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Subramanyam AA, Singh S, Raut NB, John T. Disability Assessment in Geriatric Psychiatry and Social Welfare Measures in Geropsychiatry in India. Indian J Psychol Med 2021; 43:S78-S87. [PMID: 34732959 PMCID: PMC8543603 DOI: 10.1177/02537176211022152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Rising population of elder people and associated rise in health problems, frailty and disabilities have significant socioeconomic and health care implications. Mental health related disability contributes significantly in the global disability statistics and is an important health and quality of life indicator. Assessment of disabilities in elderly is essential part of routine evaluation, further it also helps the clinicians in identifying current functional status and choosing and monitoring therapeutic interventions and need for social welfare schemes. METHODS In order to understand the process of disability assessment in geriatric psychiatry and to gather information about social welfare schemes a literature review in Google Scholar and PubMed electronic database, and website of various ministries under Government of India was done, using developed key search terms for articles published up to February 2021. The identified eligible articles were reviewed for ideas and concepts, which were then integrated and categorized under broader themes. Finally, the broad categories were discussed briefly based on the above framework. RESULTS Review findings are summarized under the following headings: concept of ageing and disability, assessment of disability, process of certification, and social welfare schemes. CONCLUSIONS The process of disability assessment comprises of comprehensive clinical evaluation, use of standardized rating instruments and disability certification wherever warranted or asked for. It is now being acknowledged worldwide by provisions of various social welfare benefits, that living with disability and increased care needs should be an integral part of definition of successful ageing.
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Affiliation(s)
- Alka A. Subramanyam
- Dept. of Psychiatry, T.N.M.C. & B.Y.L. Nair Charitable Hospital, Mumbai, Maharashtra, India
| | | | - Nitin B. Raut
- Dept. of Psychiatry & Drug De-addiction Centre, Lady Hardinge Medical College, New Delhi, India
| | - Thomas John
- Dr Thomas John Clinic, Ernakulam, Kochi, Kerala, India
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Development and implementation of COVID-19 safety protocols for conducting a randomized trial in global mental health: Field report from Central India. Asian J Psychiatr 2021; 63:102750. [PMID: 34304030 PMCID: PMC8280373 DOI: 10.1016/j.ajp.2021.102750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/07/2021] [Indexed: 11/20/2022]
Abstract
The COVID-19 pandemic impacted ongoing clinical trials globally resulting in the suspension, cancellation or transition to entirely remote implementation of studies. In India, the first countrywide lockdown was imposed in phases starting from March 2020 to June 2020, followed by a continued restriction on in-person activities including study procedures, which halted the ESSENCE (Enabling translation of Science to Service to ENhance Depression CarE) trial activities such as recruitment, consenting, baseline assessment, digital training orientation, face to face training and end-line assessment evaluation. This situation made it imperative to amend procedures in order to mitigate the risk and address safety requirements for participants and the research team. This paper summarizes the need, development and implementation of the protocols focused on risk reduction and safety enhancement with an objective to resume and continue the research activities while ensuring the safety of study participants and research staff. These protocols are comprised of guidelines and recommendations based on existing literature tailored according to different components in each arm of the trial such as guidelines for supervisors, travellers, training/recruitment venue safety procedures, individual safety procedures; and procedures to implement the study activities. These protocols can be adapted by researchers in other settings to conduct research trials during pandemics such as COVID-19.
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103
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PVSN KK, Mitra P, Ghosh R, Gangam S, Sharma S, Nebhinani N, Sharma P. Association of the NOTCH4 gene polymorphism with schizophrenia in the Indian population. Meta Gene 2021. [DOI: 10.1016/j.mgene.2021.100903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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104
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Ghannoum MA, Ford M, Bonomo RA, Gamal A, McCormick TS. A Microbiome-Driven Approach to Combating Depression During the COVID-19 Pandemic. Front Nutr 2021; 8:672390. [PMID: 34504858 PMCID: PMC8421528 DOI: 10.3389/fnut.2021.672390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/30/2021] [Indexed: 12/18/2022] Open
Abstract
The significant stressors brought about and exacerbated by COVID-19 are associated with startling surges in mental health illnesses, specifically those related to depressive disorders. Given the huge impact of depression on society, and an incomplete understanding of impactful therapeutics, we have examined the current literature surrounding the microbiome and gut-brain axis to advance a potential complementary approach to address depression and depressive disorders that have increased during the COVID-19 pandemic. While we understand that the impact of the human gut microbiome on emotional health is a newly emerging field and more research needs to be conducted, the current evidence is extremely promising and suggests at least part of the answer to understanding depression in more depth may lie within the microbiome. As a result of these findings, we propose that a microbiome-based holistic approach, which involves carefully annotating the microbiome and potential modification through diet, probiotics, and lifestyle changes, may address depression. This paper's primary purpose is to shed light on the link between the gut microbiome and depression, including the gut-brain axis and propose a holistic approach to microbiome modification, with the ultimate goal of assisting individuals to manage their battle with depression through diet, probiotics, and lifestyle changes, in addition to offering a semblance of hope during these challenging times.
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Affiliation(s)
- Mahmoud A. Ghannoum
- Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH, United States
- University Hospitals Cleveland Medical Center, Cleveland, OH, United States
- BIOHM Health LLC, Cleveland, OH, United States
| | | | - Robert A. Bonomo
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, United States
| | - Ahmed Gamal
- Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH, United States
| | - Thomas S. McCormick
- Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH, United States
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105
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Roy A, Singh AK, Mishra S, Chinnadurai A, Mitra A, Bakshi O. Mental health implications of COVID-19 pandemic and its response in India. Int J Soc Psychiatry 2021; 67:587-600. [PMID: 32873106 PMCID: PMC7468668 DOI: 10.1177/0020764020950769] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Mental health concerns and treatment usually take a backseat when the limited resources are geared for pandemic containment. In this global humanitarian crisis of the COVID-19 pandemic, mental health issues have been reported from all over the world. OBJECTIVES In this study, we attempt to review the prevailing mental health issues during the COVID-19 pandemic through global experiences, and reactive strategies established in mental health care with special reference to the Indian context. By performing a rapid synthesis of available evidence, we aim to propose a conceptual and recommendation framework for mental health issues during the COVID-19 pandemic. METHODS A search of the PubMed electronic database and google scholar were undertaken using the search terms 'novel coronavirus', 'COVID-19', 'nCoV', SARS-CoV-2, 'mental health', 'psychiatry', 'psychology', 'anxiety', 'depression' and 'stress' in various permutations and combinations. Published journals, magazines and newspaper articles, official webpages and independent websites of various institutions and non-government organizations, verified social media portals were compiled. RESULTS The major mental health issues reported were stress, anxiety, depression, insomnia, denial, anger and fear. Children and older people, frontline workers, people with existing mental health illnesses were among the vulnerable in this context. COVID-19 related suicides have also been increasingly common. Globally, measures have been taken to address mental health issues through the use of guidelines and intervention strategies. The role of social media has also been immense in this context. State-specific intervention strategies, telepsychiatry consultations, toll free number specific for psychological and behavioral issues have been issued by the Government of India. CONCLUSION Keeping a positive approach, developing vulnerable-group-specific need-based interventions with proper risk communication strategies and keeping at par with the evolving epidemiology of COVID-19 would be instrumental in guiding the planning and prioritization of mental health care resources to serve the most vulnerable.
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Affiliation(s)
- Adrija Roy
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Arvind Kumar Singh
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Shree Mishra
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Aravinda Chinnadurai
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Arun Mitra
- Independent Researcher, Bhubaneswar, Odisha, India
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Choudhry FR, Khan N, Munawar K. Barriers and facilitators to mental health care: A systematic review in Pakistan. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1941563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Fahad Riaz Choudhry
- Department of Psychology, Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, Kuala Lumpur, Malaysia
| | - Nashi Khan
- Project Director/ Dean, FSS, Rashid Latif Khan University & Director, Counselling & Wellness Centre (CWC), Rashid Latif Medical Complex (RLMC), Lahore, Pakistan
| | - Khadeeja Munawar
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University, No. 1, Jalan Menara Gading, UCSI Heights (Taman Connaught), Cheras, Kuala Lumpur, Malaysia
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Sharma G, Gujral JS, Agarwal A, Jat M, Mohanty S, Pandey RM. Exploring knowledge, attitude and practice regarding yoga among patients attending cardiology and neurology clinics in a tertiary care hospital in northern India. THE NATIONAL MEDICAL JOURNAL OF INDIA 2021; 34:201-205. [PMID: 35112541 DOI: 10.25259/nmji_11_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background The use of complementary and alternative medicine, particularly yoga is increasing in non-communicable diseases (NCDs). We assessed the overall awareness regarding yoga among patients and their opinion about it as an adjunct therapy for NCDs. Methods We included 384 patients attending the cardiology and neurology clinics at a tertiary care centre in northern India. A questionnaire was developed to assess the knowledge, attitude and practice of yoga as a therapy. Results Ninety per cent of patients were aware of yoga, mainly through print and electronic media. Of the surveyed patients, 22% practised yoga. Lack of time and knowledge were cited as the main reasons for non-practice among the non-practising patients (88%), of which 82% believed that yoga could be practised along with modern medicine. In addition, 61% were ready to accept treatment if offered at the surveyed tertiary care centre. Conclusions Adequate knowledge, awareness and attitude towards yoga appears to be present in contrast to the low practice among the patient population surveyed. If implemented in an integrated fashion, the patients were willing to accept yoga as an adjunct therapy for their cardiac and neurological disorders-an encouraging sign given the burden of NCDs in India.
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Affiliation(s)
- Gautam Sharma
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Jaskaran Singh Gujral
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Aman Agarwal
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Mansingh Jat
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Sriloy Mohanty
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - R M Pandey
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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108
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Srikanth P, Vranda MN, Thomas PT, Raghvendra K. Quality of Life and Stigma among Women with Epilepsy during Their Reproductive Years. J Epilepsy Res 2021; 11:63-71. [PMID: 34395225 PMCID: PMC8357557 DOI: 10.14581/jer.21009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Purpose The purpose of this study was to understand the relationship between quality of life and stigma among reproductive age group women with epilepsy. Methods A cross-sectional descriptive study was conducted to assess the data from the 49 women with epilepsy from a tertiary care hospital in India. Quality of life was evaluated with the quality of life in epilepsy-31 questionnaire and stigma was evaluated with the stigma scale of epilepsy. Data also included socio-demographic and clinical characteristics. Results The mean age of the participants was 24.67±3.72 years. Quality of life total score (r=−0.485**) and seizure worry domain (r=−0.427**) were significantly negatively correlated with stigma total score at p<0.01 level. Being uneducated, married, unemployed, having children, having generalized tonic-clonic seizures, duration of illness (>10 years), and consuming levetiracetam, anti-epileptic drug (AED), were the significant contributing factors for low quality of life among women with epilepsy during the reproductive age group. Belonging to lower socio-economic status and taking more than two AEDs were also associated with lower quality of life among women with epilepsy, which are trending towards significance. Conclusions The study assessed the relationship between the quality of life and the Stigma scale of epilepsy and demonstrated the impact of stigma and quality of life on socio-demographic and clinical variables of women with epilepsy under the reproductive age group. To enhance the quality of life and reduce the stigma levels among women with epilepsy, some of the modifiable parameters can be considered by the multidisciplinary health care professionals from the findings of the current research.
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Impact of COVID-19 pandemic related lockdown on Suicide: Analysis of newspaper reports during pre-lockdown and lockdown period in Bangladesh and India. Asian J Psychiatr 2021; 60:102649. [PMID: 33887672 PMCID: PMC9760196 DOI: 10.1016/j.ajp.2021.102649] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/18/2021] [Accepted: 04/05/2021] [Indexed: 11/20/2022]
Abstract
The economic and social devastation wrought by the COVID-19 crisiscoupled with the unavailability of traditional coping resources is a "perfect storm" for suicide. Evidence suggests that its impact may be disproportionately high in low-and-middle-income countries. The study aimed to assess and compare nature and correlates of suicidesfrom news reportsduring the immediate pre-lockdown and lockdown phase of COVID-19 in Bangladesh and India. We performed analysis of suicide reports from purposively selected online vernacular and English newspapers of Bangladesh and two states/union territory in India, between January to June 2020. We divided the time period of observation into two phases: pre-lockdown and lockdown phase. Country wise findings between the two phases were compared in terms of demographic and characteristics of the reported suicide. A total of 769 news reports wereanalysed; 141 from Bangladesh and 628 from India. When compared to the pre-lockdown period, the odds of suicide by hanging was significantly higher during lockdownin India (adjusted Odds Ratios [aOR] = 3.8, p = 0.018) and Bangladesh (aOR = 3.1, p = 0.048). Suicide demographics in India were different from Bangladesh during lockdown; more males died by suicide in India (aOR = 2.7, p = 0.023) and more people died by hanging (aOR = 2.6, p = 0.029). The pandemic restrictions impacted suicide demographics in the studied regions of India and Bangladesh. Further research using population-based time-series data are warranted to investigate the issue.
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110
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Banerjee D, Vajawat B, Varshney P. Digital gaming interventions: a novel paradigm in mental health? Perspectives from India. Int Rev Psychiatry 2021; 33:435-441. [PMID: 33210563 DOI: 10.1080/09540261.2020.1839392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The mental health gap has been a persistent concern globally, especially in low and middle-income countries (LMIC). In an attempt to mitigate resource limitations, the psychiatric practice has been undergoing a paradigm shift into digitalized mental health interventions. One such innovation involves digital gaming utilizing the principles of 'gamification' to incorporate both the playfulness component of online gaming as well as the domain-targeted design of gaming elements. Digital gaming-based interventions have been to deliver psychotherapy, biofeedback, cognitive training and rehabilitation, as well as behavioural modification and social skills training. Research shows their utility in autism spectrum disorders, attention deficit disorders, schizophrenia, depression, anxiety disorders, post-traumatic stress, eating disorders, neurocognitive disorders and also to promote healthy aging. Though promising in scope, these interventions face pragmatic challenges for implementation in developing countries. Even though increased use of technology, internet penetration and growing digital literacy have enhanced their accessibility and feasibility, various factors like socio-cultural diversity, lack of standardization, poor infrastructural support, bandwidth issues and lack of practice can impair their use and acceptability. Keeping this in the background, this commentary critically discusses the scope, applications and challenges of digital gaming in mental healthcare delivery in one of the rapidly globalizing LMIC nations, India.
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Affiliation(s)
- Debanjan Banerjee
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Bhavika Vajawat
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Prateek Varshney
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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111
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Grover S, Mehra A, Sahoo S, Avasthi A, Rao TSS, Vaishnav M, Dalal PK, Saha G, Singh OP, Chakraborty K, Janardran Reddy YC, Rao NP, Tripathi A, Chadda RK, Mishra KK, Rao GP, Kumar V, Gautam S, Sarkar S, Krishnan V, Subramanyam A. Evaluation of Psychological Impact of COVID-19 on Health-Care Workers. Indian J Psychiatry 2021; 63:222-227. [PMID: 34211213 PMCID: PMC8221203 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_1129_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/19/2020] [Accepted: 03/02/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Little information is available from India about the psychological impact of COVID-19 on helath-care workers. AIM The current study aimed to evaluate the psychological issues among the health-care workers (HCW) during the COVID-19 pandemic. MATERIALS AND METHODS An online survey using Survey Monkey® platform was carried out to evaluate depression (using Patient Health Questionnaire-9), anxiety (using Generalized Anxiety Disorder Questionnaire-7), and other psychological issues (using a self-designed questionnaire). RESULTS The study sample comprised 303 participants with a mean age of 41.2 (standard deviation: 11.1) years. A majority of them were male (69%) and married (79.9%). Nearly half (46.2%) of the participants had either anxiety disorder or depression or both and 12.9% of HCW had suicidal behavior. Higher level of anxiety and depression scores were associated with being female, having undergone quarantine, directly involved in the care of COVID-19 patients, and younger age (<30 years). Higher prevalence of depression and anxiety disorder was seen in younger (<30 years) age group, being a doctor (compared to paramedics). In addition, higher prevalence of depression was seen in those who were directly involved in the care of patients with COVID-19 infection. CONCLUSION About half of the HCWs are suffering from psychiatric morbidity, specifically anxiety, in the wake of the COVID-19 pandemic. There is a need to assess all the HCWs for psychiatric morbidity and provide them with psychological support.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Aseem Mehra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Swapnajeet Sahoo
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Ajit Avasthi
- Department of Psychiatry, CMC, Chandigarh, Punjab, India
- Department of Psychiatry, Fortis Hospital, Mohali, Punjab, India
| | - T. S. Sathyanarayana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, India
| | - Mrugesh Vaishnav
- Samvedana Group of Hospital and Research Centre, Ahmadabad, Gujarat, India
| | - P. K. Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Gautam Saha
- Clinic Brain Neuropsychiatric Institute and Research Center, Kolkata, India
| | | | - Kaustav Chakraborty
- Department of Psychiatry, College of Medicine and JNM Hospital, WBUHS, Kalyani, West Bengal, India
| | | | - Naren P. Rao
- Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rakesh K. Chadda
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - K. K. Mishra
- Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Wardha, India
| | | | | | - Shiv Gautam
- Gautam Hospital and Research Center, Jaipur, Rajasthan, India
| | - Siddharth Sarkar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Krishnan
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Alka Subramanyam
- Department of Psychiatry, TNMC and BYL Nair Ch. Hospital, Mumbai, Maharashtra, India
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112
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Venkatesan V, Khess CRJ, Shreekantiah U, Goyal N, Kshitiz KK. Response Processes to Looming Appetitive and Aversive Cues in Euthymic Bipolar Patients and Their First-Degree Relatives: An Exploratory Study. Indian J Psychol Med 2021; 43:209-216. [PMID: 34345096 PMCID: PMC8287393 DOI: 10.1177/0253717620975285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Patients with bipolar disorder demonstrate increased sensitivity to appetitive/rewarding stimuli even during euthymia. On presentation of arousing pictures, they show a peculiar response, suggesting heightened vigilance. While responding to looming arousing cues, studies show subjects with anxiety spectrum disorders exhibit increased reaction time (RT), explained by the "looming-vulnerability model." This study aimed to investigate the responses to looming arousing cues in euthymic bipolar patients and their first-degree relatives, as compared to healthy controls. METHOD A looming appetitive and aversive cue paradigm was designed for assessing the RT of patients to process appetitive and aversive cues. The behavioral inhibition/activation and sensitivity to reward/punishment amongst the groups were also assessed. RESULTS The bipolar group showed significantly longer RT to process appetitive cues irrespective of the looming condition. Aversive cues elicited significantly longer RT in both the bipolar group and in first-degree relatives, but only when presented with the looming condition. Significant looming bias was elicited in the bipolar group which suggested a particular cognitive style to looming cues. A composite measure of RT along with sensitivity to reward/punishment distinguishes the bipolar group and their first-degree relatives from the healthy controls. CONCLUSION The looming vulnerability model may provide important insights for future exploration of cognitive endophenotypes in bipolar disorder.
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Affiliation(s)
- Velprashanth Venkatesan
- K. S. Mani Centre for Cognitive
Neurosciences and Dept. of Psychiatry, Central Institute of Psychiatry, Ranchi,
Jharkhand, India
| | - Christoday R J Khess
- S. S. Raju Centre for Deaddiction
Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | - Umesh Shreekantiah
- K. S. Mani Centre for Cognitive
Neurosciences and Dept. of Psychiatry, Central Institute of Psychiatry, Ranchi,
Jharkhand, India
| | - Nishant Goyal
- K. S. Mani Centre for Cognitive
Neurosciences and Dept. of Psychiatry, Central Institute of Psychiatry, Ranchi,
Jharkhand, India
| | - K. K. Kshitiz
- Dept. of Biochemistry, Central
Institute of Psychiatry, Ranchi, Jharkhand, India
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113
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Ganesh UM, Shwetha Ts, Bhandary RP. Social Cognition and Neuro-cognition in Patients with Bipolar Disorder, Their First-Degree Relatives and Healthy Controls. Indian J Psychol Med 2021; 43:203-208. [PMID: 34345095 PMCID: PMC8287400 DOI: 10.1177/0253717620957936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Studies focusing on assessing social cognition deficits in schizophrenia have been expanded to bipolar disorder considering the similarities shared between the two conditions. Existing research has identified significant deficits in social cognitive skills independent of mood states and neurocognitive deficits, which could indicate the potentiality of this domain to be an endophenotype for bipolar disorder. METHODS The current study assesses the impairments in social cognition in patients with bipolar disorder and their first degree relatives, simultaneously testing for neurocognition as well, and comparing their performance to healthy controls. Fifty four participants were recruited, with 18 participants in each group. MATRICS Consensus Cognitive Battery was used to test neurocognition and Social Cognition Rating Tool in Indian Setting was administered for testing social cognition. RESULTS Significant deficits were found in social cognition and neurocognition (at p<.01) in the patient group when compared to both probands and healthy controls but no difference between probands and healthy controls. This finding established impairments in socio-cognitive functioning in remitted patients. Conclusion: The study has identified persistent deficits in social and neuro-cognition despite remission, having significant clinical implications in terms developing remediation programs for social cognition and planning early intervention as social cognition deficits have been identified as potential risk factors.
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Affiliation(s)
- Uma Maheswari Ganesh
- Dept. of Clinical Psychology, SriRamchandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India
| | - Shwetha Ts
- Dept. of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajeshkrishna P Bhandary
- Dept. of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Kanougiya S, Daruwalla N, Gram L, Gupta AD, Sivakami M, Osrin D. Economic abuse and its associations with symptoms of common mental disorders among women in a cross-sectional survey in informal settlements in Mumbai, India. BMC Public Health 2021; 21:842. [PMID: 33933060 PMCID: PMC8088652 DOI: 10.1186/s12889-021-10904-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/21/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Domestic violence takes a range of interconnected forms, of which economic abuse is common, but less studied than others. We examine the prevalence of economic abuse, its determinants, and its association with symptoms of depression, anxiety, and suicidal ideation. METHODS Our cross-sectional survey in informal settlement areas in Mumbai, India, asked women aged 18-49 years 15 questions about acquisition, use, and maintenance of economic resources, demographic and socioeconomic factors, and physical, sexual, and emotional violence. We administered the Patient Health Questionnaire 9 (PHQ-9) and Generalised Anxiety Disorder 7 (GAD-7) scales and asked about suicidal thinking. Determinants of economic abuse and its associations with positive screens for depression and anxiety were explored in univariable and multivariable logistic regression models. RESULTS Of 4906 ever-married women respondents, 23% reported at least one form of economic abuse by either an intimate partner or another family member. The commonest were denial of property rights (10%), not being trusted with money (8%), and coercive appropriation of belongings (7%). Economic abuse was more commonly reported by widowed, separated, or divorced women than by married women (aOR 12.4; 95% CI 6.4, 24.1), and when their partners used alcohol or drugs (aOR 1.4; 95% CI 1.2-1.7). Women had greater odds of reporting economic abuse if they had suffered emotional (aOR 6.3; 95% CI 5.0-7.9), physical (aOR 1.9; 95% CI 1.4-2.6), or sexual violence (aOR 5.4; 95% CI 3.6-8.1) in the preceding 12 months. Economic abuse was independently associated with positive screens for moderate-severe depression (aOR 2.6; 95% CI 2.0-3.4), anxiety (aOR 2.7; 95% CI 1.9-3.8), and suicidal ideation (aOR 2.2; 95% CI 1.5-3.1). The odds of anxiety and depression increased with each additional form of economic abuse. DISCUSSION To our knowledge, this is the first community-based study in India of the prevalence of economic abuse and its associations with symptoms of common mental disorders. It provides empirical support for the idea that economic abuse is at least as harmful to women's mental health as physical violence. Surveys should include questions on economic abuse and prevention and intervention strategies need to help survivors to understand its forms.
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Affiliation(s)
- Suman Kanougiya
- Program on Prevention of Violence Against Women and Children, SNEHA, Mumbai, Maharashtra 400017 India
- School of Health Systems Studies (SHSS), Tata Institute of Social Sciences (TISS), Mumbai, Maharashtra, India
| | - Nayreen Daruwalla
- Program on Prevention of Violence Against Women and Children, SNEHA, Mumbai, Maharashtra 400017 India
| | - Lu Gram
- Institute for Global Health, University College London, London, WC1N IEH UK
| | - Apoorwa Deepak Gupta
- Program on Prevention of Violence Against Women and Children, SNEHA, Mumbai, Maharashtra 400017 India
| | - Muthusamy Sivakami
- School of Health Systems Studies (SHSS), Tata Institute of Social Sciences (TISS), Mumbai, Maharashtra, India
| | - David Osrin
- Institute for Global Health, University College London, London, WC1N IEH UK
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Sarveswaran G, Jayaseelan V, Krishnamoorthy Y, Sakthivel M, Arivarasan Y, Vijayakumar K, Marimuthu Y. Perceived Stress and Its Determinants among Postmenopausal Women in Urban Puducherry. J Midlife Health 2021; 12:33-38. [PMID: 34188424 PMCID: PMC8189331 DOI: 10.4103/jmh.jmh_127_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/05/2020] [Accepted: 10/01/2020] [Indexed: 11/18/2022] Open
Abstract
Background: Menopause characterized by a gradual decline in ovarian hormones takes its toll on the women both physically and mentally. These health problems can negatively impact the mental status. Hence, the current study was done to determine the level of stress and its associated factors among postmenopausal women in urban Puducherry, India. Materials and Methods: A facility-based cross-sectional study was done among 219 postmenopausal women attending the outpatient department in urban primary health center during May 2017–June 2017. Information regarding sociodemographic profile was collected using pretested semi-structured questionnaire and Cohen's Perceived Stress Scale was used to assess the stress level. We calculated adjusted prevalence ratios (aPRs) to identify the determinants of stress. Results: Among 219 participants, 46.6% were in the age group of 60–74 years; 32.9% had primary to secondary level of education; 56.2% were unemployed; 42.5% belonged to lower socioeconomic class; and 32.9% had both diabetes mellitus and hypertension. The prevalence of stress among the postmenopausal women was 26.0% (95% confidence interval: 20.7–32.2). Postmenopausal woman with higher education (aPR – 2.18), belonging to nuclear family (aPR – 1.93), lesser parity (aPR – 1.18), and current alcohol/tobacco users (aPR-2.32) were found to have a significant association with stress among the study participants. Conclusion: The current study showed that more than one-fourth of the postmenopausal women had high to very high level of stress. Education, religion, parity, and substance abuse were the significant determinants of stress. However, further longitudinal research needs to be done to determine whether the factors informed in the current study are truly associated with stress and develop interventions accordingly.
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Affiliation(s)
- Gokul Sarveswaran
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Venkatachalam Jayaseelan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Yuvaraj Krishnamoorthy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Manikandanesan Sakthivel
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Yashodha Arivarasan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Karthiga Vijayakumar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Yamini Marimuthu
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Parameshwaran D, Sathishkumar S, Thiagarajan TC. The impact of socioeconomic and stimulus inequality on human brain physiology. Sci Rep 2021; 11:7439. [PMID: 33811239 PMCID: PMC8018967 DOI: 10.1038/s41598-021-85236-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/19/2021] [Indexed: 02/01/2023] Open
Abstract
The brain undergoes profound structural and dynamical alteration in response to its stimulus environment. In animal studies, enriched stimulus environments result in numerous structural and dynamical changes along with cognitive enhancements. In human society factors such as education, travel, cell phones and motorized transport dramatically expand the rate and complexity of stimulus experience but diverge in access based on income. Correspondingly, poverty is associated with significant structural and dynamical differences in the brain, but it is unknown how this relates to disparity in stimulus access. Here we studied consumption of major stimulus factors along with measurement of brain signals using EEG in 402 people in India across an income range of $0.82 to $410/day. We show that the complexity of the EEG signal scaled logarithmically with overall stimulus consumption and income and linearly with education and travel. In contrast phone use jumped up at a threshold of $30/day corresponding to a similar jump in key spectral parameters that reflect the signal energy. Our results suggest that key aspects of brain physiology increase in lockstep with stimulus consumption and that we have not fully appreciated the profound way that stimulus expanding aspects of modern life are changing our brain physiology.
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Affiliation(s)
| | - S. Sathishkumar
- Sapien Labs, 1201 Wilson Drive 27th Floor, Arlington, VA 22209 USA
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Singh SM, Shouan A, Sai Chiatanya Reddy B, Suman A, Kathiravan S, Pal P, Yadav V. Proactive case finding for severe mental illness in a rural area in the Indian Punjab: findings and lessons. Soc Psychiatry Psychiatr Epidemiol 2021; 56:707-710. [PMID: 33155122 DOI: 10.1007/s00127-020-01982-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/24/2020] [Indexed: 10/23/2022]
Abstract
People with severe mental illnesses may experience barriers in accessing community mental health services. We used the key informant method to detect people with untreated severe mental illness in seven villages in the Indian state of Punjab. The key informant was a local community leader. We were able to contact 11 patients who were identified as suffering from severe mental illness by the key informants. On assessment, eight of them had intellectual disability and three had psychotic and affective illness. We discuss the barriers and opportunities for providing mental health services in the community.
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Affiliation(s)
- Shubh Mohan Singh
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - Anish Shouan
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - B Sai Chiatanya Reddy
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aarzoo Suman
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjana Kathiravan
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Prit Pal
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikram Yadav
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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118
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Sutar R, Lahiri A, Diwan S, Satpathy P, Rozatkar A. Determinants of Mental Health Care Access in a Tribal District of Central India: Findings from a Health Camp. J Neurosci Rural Pract 2021; 12:335-342. [PMID: 33935448 PMCID: PMC8079175 DOI: 10.1055/s-0041-1723071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective Mental health care needs of urban, rural, and tribal regions of India are varied and challenging, which require region-specific approaches. A significant treatment gap calls out for a state-wise introspection of existing service delivery models to cater to the specific mental health needs. In Madhya Pradesh, key findings were noted from a camp conducted in one of the tribal districts. To establish patient-centered services, it is important to understand their mental health care needs. Materials and Methods A cross-sectional study within a mental health camp was conducted in the east-central tribal district of Madhya Pradesh by using a semi-structured interview. Statistical Analysis Treatment deficit, pathways to care, and treatment barriers were assessed for correlation with demographic and clinical variables and analyzed by using the Chi-square test and logistic regression method using SPSS version 20. Results Among 113 patients who sought help, treatment deficit was 85% with patient factors contributing 76% predominantly affecting the unmarried group of patients. Common mental illnesses (CMIs) outnumbered severe mental illnesses (SMIs) of which anxiety spectrum disorder contributed the most. SMIs still appear to remain undiagnosed till late in the course of illness. Nicotine dependence was higher in males ( p < 0.001), and an increase in the dependence pattern was observed with increasing age ( p = 0.001). Conclusion Rising awareness and recognition of CMIs as a common mental health concern while under-recognition of SMIs among tribal communities needs further research. Considering attribution of symptoms to unknown factors, treatment barriers revolving around patient factors, and higher nicotine dependence in males, a timely evaluation of a multitargeted intervention to establish the balance in access to mental health care among the tribal population of Madhya Pradesh is warranted.
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Affiliation(s)
- Roshan Sutar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, India
| | - Anuja Lahiri
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Sanjeet Diwan
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, India
| | - Parmeshwar Satpathy
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Abhijit Rozatkar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, India
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119
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Singh KK, Jyotirmay, Kumar A, Goel A, Gulati S, Nayak BB. Prevalence of anxiety, stress, and depression among health care and nonhealth-care professionals in India. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:83. [PMID: 34084830 PMCID: PMC8150081 DOI: 10.4103/jehp.jehp_754_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 08/22/2020] [Indexed: 09/05/2023]
Abstract
BACKGROUND The psychological impact of anxiety, stress, and depression among health care and nonhealth-care professionals in India contribute significantly to the global burden of mental illness in the world. Impaired mental health and stress influence the efficiency and productivity of work. Long-term professional stress among individuals can lead to chronic illness, increased blood pressure, and many systemic disorders. The aim of this study was to assess the prevalence of anxiety, stress, and depression among the health care and nonhealth-care professionals in India. MATERIALS AND METHODS This prospective survey-based study included 200 study participants (80 nonhealth care and 120 health-care workers) who were asked to submit their feedback and opinion on a questionnaire survey. Depression, stress, and anxiety were scored as per patient health questionnaire-4 and UCLA scale. The reliability of questionnaires was assessed using the Cronbach's alpha (r = 0.90). The statistical analysis was done using the Chi-square test. RESULTS Higher prevalence ratio of anxiety, depression, and stress was observed among nonhealth care compared to health-care professionals. CONCLUSION Psychological disturbances were found to be higher among nonmedical when compared to health-care workers or professionals. Thus, psychological counseling is required to manage the stress levels in both health care and nonhealth-care professionals.
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Affiliation(s)
| | - Jyotirmay
- Department of Orthodontics, Patna Dental College and Hospital, Patna, Bihar, India
| | - Avanindra Kumar
- Department of Oral Pathology and Microbiology, Patna Dental College and Hospital, Patna, Bihar, India
| | - Aashana Goel
- Department of Pedodontics and Preventive Dentistry, Adesh Institute of Research and Dental Sciences, Bathinda, Punjab, India
| | - Saakshi Gulati
- Department of Oral Medicine and Radiology, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Bikash Bishwadarshee Nayak
- Department of Oral Medicine and Radiology, Hi Tech Dental College and Hospital, Bhubaneswar, Odisha, India
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120
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Psychiatric Problems Among Adolescents With HIV. Indian Pediatr 2021. [PMID: 33713078 PMCID: PMC8005280 DOI: 10.1007/s13312-021-2182-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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121
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Santhosh AP, Kumar Goyal M, Modi M, Kharbanda PS, Ahuja CK, Tandyala N, Prabhat N, Singh R, Mehta S, Vinay Mahesh K. Carbamazepine versus levetiracetam in epilepsy due to neurocysticercosis. Acta Neurol Scand 2021; 143:242-247. [PMID: 33006755 DOI: 10.1111/ane.13355] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/03/2020] [Accepted: 09/24/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The choice of antiepileptic drug (AED) in newly diagnosed neurocysticercosis (NCC) patients with epilepsy continues to be arbitrary. We compared efficacy and side effect profile of levetiracetam (LEV) and carbamazepine (CBZ) for the treatment of seizures in newly diagnosed patients with NCC. PATIENTS AND METHODS This was an open-labeled randomized comparative monotherapy study including newly diagnosed drug naïve patients of NCC (n = 99) presenting with seizures who were randomized in 1:1 ratio using computed generated numbers. All patients were followed up for at least six months after start of treatment. The primary outcome measure was seizure control over six months following start of AEDs. RESULTS Fifteen (15.2%) patients [CBZ- 4(8.2%); LEV- 11(22%)] developed recurrence of seizures. A trend (p = 0.09) was found toward better control of seizures in CBZ compared to LEV. Two (4%) patients in LEV group and 17 (34.6%) patients in CBZ group developed drug-related minor side effects (p < 0.0001). Three patients in CBZ group needed discontinuation of therapy due to skin rash. Eleven patients who relapsed while on LEV did not have any recurrence of seizures after switching over to CBZ. Out of 3 patients who relapsed while receiving CBZ and were changed to LEV, two developed seizures during follow-up. CONCLUSION CBZ and LEV could be used as alternatives in newly diagnosed patients of NCC at the behest of minor side effects in the CBZ group.
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Affiliation(s)
- Akhil P. Santhosh
- Department of Internal Medicine Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Manoj Kumar Goyal
- Department of Neurology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Manish Modi
- Department of Neurology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Parampreet S. Kharbanda
- Department of Neurology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Chirag K. Ahuja
- Department of Radiodiagnosis and Imaging Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Naresh Tandyala
- Department of Neurology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Nandita Prabhat
- Department of Neurology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Rajveer Singh
- Department of Neurology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Sahil Mehta
- Department of Neurology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Karthik Vinay Mahesh
- Department of Neurology Postgraduate Institute of Medical Education and Research Chandigarh India
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Sreedaran P, Beniwal RP, Chari U, Smitha T S, Vidhya Shree S V, Gupta V, Bhatia T, Deshpande SN. A Randomized Controlled Trial to Assess Feasibility and Acceptability of Telephone-Based Psychosocial Interventions in Individuals who Attempted Suicide. Indian J Psychol Med 2021; 43:144-149. [PMID: 34376890 PMCID: PMC8313454 DOI: 10.1177/0253717620939272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Brief contact interventions such as telephone-based contacts appear to be useful in individuals who attempted suicide. Most studies of telephone-based contacts in such individuals typically consisted of frequent phone reminders for adherence to treatment and seeking help for mental health issues. Telephone-based psychosocial interventions that incorporate elements of supportive and problem-solving strategies are of interest in Indian settings due to their potential application in mitigating the wide mental health gap. Feasibility studies of telephone-based psychosocial interventions could help ascertain the difficulties that arise in the implementation of such treatments. METHODS A multicentric randomized controlled trial (RCT) is currently underway in general hospital settings in two Indian cities to study the efficacy of telephone-based psychosocial interventions in individuals with a recent suicide attempt, with routine telephone contacts (TCs) serving as the comparator. Prior to that RCT, this feasibility study was conducted to assess the acceptability of the telephone-based intervention and telephone contacts. Feasibility was assessed using dropout rates. Acceptability was assessed using participant-rated Likert-based visual analog scores from 0 to 10, with higher scores indicating greater acceptability. RESULTS Dropout rates and mean acceptability scores for telephone-based psychosocial interventions were 38.5% and 8.63, while those for TCs were 41.7% and 7.57, respectively. CONCLUSIONS Telephone-based psychosocial interventions are feasible and acceptable in individuals with a recent suicide attempt.
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Affiliation(s)
- Priya Sreedaran
- Dept. of Psychiatry, St John’s Medical
College, Bengaluru, Karnataka, India
| | - Ram Pratap Beniwal
- Dept. of Psychiatry, Centre of
Excellence in Mental Health, ABVIMS & Dr RML Hospital, New Delhi, India
| | - Uttara Chari
- Dept. of Clinical Psychology, St John’s
MEDICAL college, Bengaluru, Karnataka, India
| | - Smitha T S
- Dept. of Psychiatry, St John’s Medical
College, Bengaluru, Karnataka, India
| | - Vidhya Shree S V
- Dept. of Psychiatry, St John’s Medical
College, Bengaluru, Karnataka, India
| | - Varsha Gupta
- Dept. of Psychiatry, Centre of
Excellence in Mental Health, ABVIMS & Dr RML Hospital, New Delhi, India
| | - Triptish Bhatia
- Dept. of Psychiatry, Centre of
Excellence in Mental Health, ABVIMS & Dr RML Hospital, New Delhi, India
| | - Smita N Deshpande
- Dept. of Psychiatry, Centre of
Excellence in Mental Health, ABVIMS & Dr RML Hospital, New Delhi, India
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Ibrahim FA, Nirisha L, Barikar M, Kumar CN, Chand PK, Manjunatha N, Math SB, Thirthalli J, Manjappa AA, Parthasarathy R, Reddy S, Arora S. Identification of Psychiatric Disorders by Rural Grass-Root Health Workers: Case Series & Implications for the National Mental Health Program of India. Psychiatr Q 2021; 92:389-395. [PMID: 32772306 PMCID: PMC10035070 DOI: 10.1007/s11126-020-09807-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Auxiliary Nurse Midwife (ANMs) and Accredited Social Health Activists (ASHAs) are well suited to cater to the mental health needs of the communities. Integrating primary mental health care into the general healthcare is one of the important objectives of the District Mental Health Program (DMHP) to reduce the treatment gap. As a part of an ICMR funded trial to evaluate the effectiveness of NIMHANS-ECHO blended training program, the ASHAs and ANMs were trained to identify and refer cases from the community. We aim to describe a series of cases identified by those workers from the community, highlighting their importance in our health care system.
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Affiliation(s)
- Ferose Azeez Ibrahim
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | - Lakshmi Nirisha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | - Malathesh Barikar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | - Channaveerachari Naveen Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, 560029, India.
| | - Prabhat Kumar Chand
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | - Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | - Adarsha Alur Manjappa
- Department of Health and Family Welfare, Government of Karnataka, Bengaluru, Karnataka, India
| | - Rajani Parthasarathy
- Department of Health and Family Welfare, Government of Karnataka, Bengaluru, Karnataka, India
| | - Shanivaram Reddy
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | - Sanjeev Arora
- The ECHO Institute, University of New Mexico, Albuquerque, NM, USA
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Bhowmick S, Parolia S, Jana S, Kundu D, Choudhury D, Das N, Ray K, KarPurkaysatha S. A study on the anxiety level and stress during Covid19 lockdown among the general population of West Bengal, India- A must know for primary care physicians. J Family Med Prim Care 2021; 10:978-984. [PMID: 34041108 PMCID: PMC8138382 DOI: 10.4103/jfmpc.jfmpc_1385_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/12/2020] [Accepted: 09/24/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Covid19 pandemic has resulted in drastic changes in human lives across the globe in the form of lockdown and an uncertain future. Information regarding the COVID-19-related anxiety and well-being among the public in India is very limited, especially from the state of West Bengal. We conducted this e-survey among the general population of West Bengal to assess the anxiety levels and the well-being status during lockdown. This information would be helpful to guide family physicians to screen patients for anxiety from the primary care level. Aims: The main aim of this questionnaire based study was to assess the levels of anxiety and well-being status among the public including the frontline workers in West Bengal, India. Materials and Methods: A prospective study was conducted with a validated e-questionnaire after Institutional Ethics committee approval, from 18th April, 2020 to 3rd May, 2020. The questionnaire had 12 questions which included the Generalized Anxiety disorder (GAD)-7 scale and the WHO-5 scale (5 question-items) to assess the well-being of the participants. The survey link was distributed through the social networking sites of WhatsApp, LinkedIn, Facebook and Twitter and e-mails within West Bengal. Microsoft Excel (version 2016) was used to analyse the data. Results: A total of 355 responses were received 15.49% responders were observed to have anxiety and 37.74% participants had low well-being scores. Majority of healthcare workers (89.47%) were seen to have anxiety and a significant (52.03%) had a low well-being status. Conclusions: We report the presence of anxiety and low well-being among the general population of West Bengal. It is important to understand the current psychological status of the public for the family physicians as many would visit them with vague symptoms. There is a dire need to screen all patients including front line workers visiting primary care physicians for mental health to ensure better clinical outcome.
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Affiliation(s)
- Subhrojyoti Bhowmick
- Associate Professor, Department of Pharmacology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Saksham Parolia
- Student, PharmD, Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shubham Jana
- Ex-executive, Clinical Research Department, Peerless Hospitex Hospital and Research Center Ltd, Kolkata, West Bengal, India
| | - Debarati Kundu
- Executive, Clinical Research Department, Peerless Hospitex Hospital and Research Center Ltd, Kolkata, West Bengal, India
| | - Digbijoy Choudhury
- Associate Consultant, Family Medicine, Ruby General Hospital, Kolkata, West Bengal, India, & Spice Route India, State Lead (WB), India
| | - Nina Das
- Head, Department of Pharmacology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Krishnanghsu Ray
- Medical Director, Peerless Hospitex Hospital and Research Centre Ltd, Kolkata, West Bengal, India
| | - Sujit KarPurkaysatha
- Senior Consultant, Department of Gastroenterology, Peerless Hospitex Hospital and Research Centre Ltd, Kolkata, West Bengal, India
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Anxiety, Depression, and Post-traumatic Stress a month after 2019 Cyclone Fani in Odisha, India. Disaster Med Public Health Prep 2021; 16:670-677. [PMID: 33583466 DOI: 10.1017/dmp.2020.368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Early Identification of disaster victims with mental health problems may be useful, but information within a short period after a disaster is scarce in developing countries. This study examined anxiety, depression, and post-traumatic stress symptoms at 1 month following 2019 Cyclone Fani in Odisha, India. METHOD Post-traumatic stress symptoms (PTSS) were assessed by the Primary care PTSD screen for DSM 5 (PC-PTSD-5), anxiety symptoms by the Generalised Anxiety Disorder (GAD-7), and depression by the Patient Health Questionnaire (PHQ-9). The survey included participants' disaster experience e.g., evacuation, fear of death, injury, death in family, damage to house, difficulty for food, displacement, and effect on livelihood. RESULTS Proportion of sample (n = 80) with probable PTSD was 42.9%, with severe anxiety was 36.7%, moderately severe depression was 16.5%, and severe depression was 3.8%. Suicidal cognitions were reported to increase by 14%. Comorbidity was common; with significant (P < 0.01) correlation between PTSS and anxiety (r = 0.69), depression (r = 0.596), and between anxiety and depression (r = 0.63). Damage of house and displacement were associated significantly with PTSD; evacuation and displacement with moderate and severe depression; and displacement with severe anxiety. No specific demographic factors were significantly linked to the psychiatric morbidities. CONCLUSION A considerable proportion of victims had psychiatric morbidities at 1 month. Associated risk factors included housing damages, evacuation, and displacement, suggesting the need to improve the disaster-management process.
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Factors Associated with Mental Health Problems among Malaysian Children: A Large Population-Based Study. CHILDREN-BASEL 2021; 8:children8020119. [PMID: 33562212 PMCID: PMC7914472 DOI: 10.3390/children8020119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/02/2022]
Abstract
Mental health problems are a major public health issue, particularly among children. They impair children’s development, academic achievement, and ability to live a productive life. The present study aimed to determine the prevalence and factors associated with mental health problems among children aged 5 to 15 years old in Malaysia. Data from the National Health and Morbidity Survey (NHMS) 2015 were analyzed. A validated Strengths and Difficulties Questionnaire (SDQ) was used. The overall prevalence of mental health problems among children in Malaysia was 11.1%. Multiple logistic regression analysis revealed that for every year increment in age, mental health problems decreased by 5%. Further analysis found that children who had fathers with a non-formal education and worked in the private sector, had parents who were widowed or divorced, and had either parent with mental health problems were more likely to have mental health problems themselves. Children from the lower socioeconomic group and who had either parent with mental health problems had higher odds of having mental health problems in Malaysia.
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Iyer S, Shriraam V. Prevalence of Eating Disorders and Its Associated Risk Factors in Students of a Medical College Hospital in South India. Cureus 2021; 13:e12926. [PMID: 33654608 PMCID: PMC7907547 DOI: 10.7759/cureus.12926] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and objectives Eating disorders are some of the most under-researched and difficult to diagnose psychiatric conditions, with a high mortality rate, especially among the adolescent age group. The aim of this study is to determine the prevalence and risk factors for eating disorders among students of a medical college hospital in South India. Materials and methods An observational, cross-sectional study was conducted among 332 students of four constituent colleges of a tertiary-care hospital selected by simple random sampling. Their height and weight were recorded. Four major questionnaires were distributed among the students - Demographic details, Eating Attitudes Test (EAT26), Body Shape Questionnaire (BSQ34), and Perceived Stress Scale (PSS). The results were tabulated and analyzed using SPSS software version 16.0 (IBM Corporation, Somers, New York, USA). Results The proportion of students who had a high risk for eating disorders was 13%. It was prevalent almost equally in both males and females. High risk for eating disorders was associated with high stress and severe body shape concerns (p<0.001). Other influencing factors were history of counselling, peer pressure, excessive exercise as well as the history of any behavioral symptoms like the use of laxatives and diet pills (p<0.001). Conclusions Eating disorder risk is prevalent in a high percentage of medical and paramedical students. High stress and body shape concerns are associated with eating disorders. Only if diagnosed early, with screening programs using questionnaires and further psychiatric evaluation, we can hope to mitigate the complications they incur.
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Affiliation(s)
- Shruti Iyer
- Community Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Vanishree Shriraam
- Community Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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Kalita J, Tripathi A, Dongre N, Misra UK. Impact of COVID-19 pandemic and lockdown in a cohort of myasthenia gravis patients in India. Clin Neurol Neurosurg 2021; 202:106488. [PMID: 33460984 PMCID: PMC7803624 DOI: 10.1016/j.clineuro.2021.106488] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/02/2021] [Accepted: 01/08/2021] [Indexed: 12/15/2022]
Abstract
Objective Myasthenia gravis (MG) is characterized by fluctuating muscle weakness due to immune mediated damage of acetylcholine receptor (AchR). COVID-19 infection, mental stress and non-availability of drugs following lockdown may worsen myasthenic symptoms. We report the impact of COVID 19, and lockdown on the physical and mental health, and quality of sleep in a cohort of MG. Methods Thirty-eight MG patients were telephonically interviewed 2months after the declaration of lockdown in India. The difficulty in procuring drugs, complications, and worsening in the MG Foundation of America (MGFA) stage were noted. The patients were enquired about MG Quality of Life 15 (MGQOL15), MG Activity of Daily Living (MGADL), Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) using a prefixed questionnaire. Their pre-COVID parameters were retrieved from our earlier trial data, which was completed 4months back. The scores of the above mentioned parameters before and after COVID were compared. Results Their median age was 45 years, and the median duration of treatment for MG was 4.5years. Eleven (28.9 %) patients were hypertensive and 3(7.9 %) diabetic. All were on prednisolone and 18(47.4 %) received azathioprine. None developed COVID, but three had other infections. Two patients needed hospitalization because of wrong medication in one and severe anxiety-insomnia in another. Following COVID19 and lockdown, MG patients had worsening in MGQOL15, MGADL, HADS and PSQI scores. Pittsburgh Sleep Quality Index score correlated with MGQOL15 and dose of acetylcholine esterase inhibitors. Conclusion COVID-19 and lockdown were associated with anxiety, depression, poor MGQOL and sleep especially in severe MG patients.
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Affiliation(s)
- Jayantee Kalita
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, 226014, India.
| | - Abhilasha Tripathi
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, 226014, India
| | - Nikhil Dongre
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, 226014, India
| | - Usha K Misra
- Department of Neurology, Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226007, India
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Priyamkari A, Akhilesh M, Kakunje A, Karkal R. Cross sectional study on burden and psychiatric morbidity in the caregivers of patients of major psychiatric illness in a tertiary healthcare centre. ARCHIVES OF MENTAL HEALTH 2021. [DOI: 10.4103/amh.amh_62_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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130
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An exploratory study of the prevalence of mental health symptoms among girls living in 5 childcare institutions in Goa and Mumbai. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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131
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Moorthi SK, Radhika P, Muraleedharan KC. Usefulness of individualised homoeopathic medicine in Manic episode - A case report. INDIAN JOURNAL OF RESEARCH IN HOMOEOPATHY 2021. [DOI: 10.4103/ijrh.ijrh_25_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Improving Social Inclusion for Young People Affected by Mental Illness in Uttarakhand, India. Community Ment Health J 2021; 57:136-143. [PMID: 32333229 DOI: 10.1007/s10597-020-00623-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 04/13/2020] [Indexed: 10/24/2022]
Abstract
Young people experiencing mental ill-health are often excluded from peer networks, family events, education, marriage and employment. We evaluated a community-based, peer-led intervention guided by the Nae Disha (new pathways) program, targeting young people affected by mental ill-health in Uttarakhand, India. A total of 11 groups involving 142 young people (30 male, 112 female) and 8 peer facilitators participated, most of whom were enrolled in a community mental health program. The impact of the intervention on participation, mental health, and social strengths and difficulties was measured at baseline and endline using validated instruments. The proportion experiencing significant social isolation reduced from 20.6 to 5.9% (p < 0.001), and those classified in the 'abnormal' range of the social difficulties measure halved from 42.6 to 21.3% (p < 0.001). These findings clearly demonstrate that perceptions of social inclusion and mental health of young people affected by mental illness can be significantly strengthened through participation in this low-resource intervention.
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Jena S, Zieger A, Böge K, Salunkhe G, Schomerus G, Patel K, Padhi BK, Ta TMT, Mungee A, Hahn E. Public Attitudes Toward Psychiatric Hospitals: A Rural-Urban Comparative Public Survey in Odisha State, India. Front Psychiatry 2021; 12:745604. [PMID: 34658978 PMCID: PMC8517327 DOI: 10.3389/fpsyt.2021.745604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Integration of psychiatric care with public health services and offering mental health care services to patients from lower socioeconomic status remains a global challenge. Scarcity of funds and professional workforce in psychiatric hospitals contribute to this situation. However, negative attitudes in the population are also a known impediment to patients seeking mental health services. This study aimed to assess the attitudes toward psychiatric hospitals among the urban and rural population in India. Subjects and Methods: The study was carried out amongst the general population in Odisha, India. The total sample (n = 988) includes 496 respondents from an urban-setting, and 492 respondents from rural parts of the district. Participants were selected by using simple random-sampling from the Asian Institute of Public Health (AIPH) data base. A standardized seven-item questionnaire was adopted, with responses indicated on a 5-point Likert-scale. Interviews were fully structured and conducted face-to-face. Results: Level of education (B = -0.192, ß = -0.320, p < 0.000) and urban-rural comparison (B = -0.272, ß = -0.189, p < 0.000) significantly influenced attitudes toward psychiatric hospitals. Gender, age, and religious beliefs did not show any significant effect on attitudes toward psychiatric hospitals. Individuals in rural areas and those with lower education levels showed more negative attitudes toward psychiatric hospitals. Conclusion: Negative attitudes toward psychiatric hospitals from those living in rural areas as well as those with lesser education may be reflective of the lack of availability, accessibility, affordability, and credibility of such mental health services. The Mental Health Care Act in India is a progressive legislation which might improve the situation of the provided services and, consequently, reduce negative attitudes in the years to come.
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Affiliation(s)
- Sunita Jena
- Asian Institute of Public Health, Utkal University, Bhubaneswar, India
| | - Aron Zieger
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Berlin, Germany
| | - Gayatri Salunkhe
- Center of Medicine and Society, University of Freiburg, Freiburg, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Kripalini Patel
- Asian Institute of Public Health, Utkal University, Bhubaneswar, India
| | - Bijaya Kumar Padhi
- Asian Institute of Public Health, Utkal University, Bhubaneswar, India.,Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Thi Minh Tam Ta
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Berlin, Germany
| | - Aditya Mungee
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Berlin, Germany
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Sinha P, Hussain T, Boora NK, Rao GN, Varghese M, Gururaj G, Benegal V. Prevalence of Common mental disorders in older adults: Results from the National Mental Health Survey of India. Asian J Psychiatr 2021; 55:102463. [PMID: 33212298 DOI: 10.1016/j.ajp.2020.102463] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/29/2020] [Accepted: 10/25/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We estimate the prevalence of common mental disorders (CMD) among older adults and compare them with that of younger adults at the national level. METHOD We analysed data on older adults from the National Mental Health Survey of India undertaken across 6 regions and 12 states of India during 2015-16. Multi-stage cluster sampling technique was adopted which permitted state level and subsequently pooled national estimates. Mini International NeuroPsychiatric Interview (MINI) adult version 6.0 was used for measuring psychiatric morbidity. RESULTS Older adults had a higher lifetime (6.93%) and current (3.53%) prevalence of depressive disorders as compared to the younger adults (4.96% and 2.54%). There was no difference in the prevalence of anxiety disorders in different agegroups. The most prevalent anxiety disorder in older adults was specific phobias (1.72%) followed by agoraphobia (1.6%). All CMD in the older population were more common in females, those living in urban metros, the unemployed, who were not currently married and those with lower household income. DISCUSSION These findings support planning better mental health policies and programs for older adults in India.
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Affiliation(s)
- Preeti Sinha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Tajamul Hussain
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Naveen Kumar Boora
- Department of Epidemiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Girish N Rao
- Department of Epidemiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
| | - G Gururaj
- Department of Epidemiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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Banerjee D. ' All that Followed a Death. . .': An Alleged Celebrity Suicide, Media Discourse and Mental Health. Int J Soc Psychiatry 2020:20764020985572. [PMID: 33356758 DOI: 10.1177/0020764020985572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mortality and morbidity due to suicides have been an ever-growing burden in India. The public response to the understanding of suicidal deaths and popular perceptions are heavily dependent on media discourse and reporting of such cases. Recently, the alleged death of a young Indian celebrity due to suicide in India led to a media debacle that quickly spurred into endless speculations and sensational reporting of the associated details. Incidents of high-profile suicide often cause varied perceptions, attitudes and beliefs related to the 'act' that can get further compounded by misinformation and media-portrayal of the same. Recent cross-sectional research by Raj et al. (2020) explores the adherence of Indian media reporting of suicides for a month after the celebrity-death. It reveals that more than 80% of the news articles deviate from the prevalent Press Council of India (PCI) and the World Health Organization (WHO) guidelines for media-reporting of suicides. With this study in the background, the commentary contextualizes its findings in the Indian socio-cultural scenario, reviews the influence of media on public attitudes toward suicide, and highlights the need for active media-public health collaboration as a part of a national suicide prevention strategy. Suicides need to be viewed beyond just the 'medical or psychological health' model through a more holistic biopsychosocial framework.
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Affiliation(s)
- Debanjan Banerjee
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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136
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Zodpey S, Negandhi P. Inequality in health and social status for women in India - A long-standing bane. Indian J Public Health 2020; 64:325-327. [PMID: 33318379 DOI: 10.4103/ijph.ijph_1312_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sanjay Zodpey
- Advisory Board Member of Indian Journal of Public Health; Vice President, Public Health Foundation of India, Gurgaon, Haryana, India
| | - Preeti Negandhi
- Additional Professor, Indian Institute of Public Health Delhi, Public Health Foundation of India, Gurgaon, Haryana, India
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Kaur J, Verma VC, Kumar V, Singh R, Bhatia T, Sahu S, Manak M, Buttolia HK, Choudhary B, Sharma YS, Shah SK, Kumar P, Kaur J, Deshpande S, Singh H. i-MANN: A Web-Based System for Data Management of Mental Health Research in India. Indian J Psychol Med 2020; 42:S15-S22. [PMID: 33487798 PMCID: PMC7802041 DOI: 10.1177/0253717620969064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND National Mental Health Program (NMHP) was launched by the government with an aim to improve mental health of the society through precise and focused interventions and policies. In order to provide reliable data and evidence for NMHP, there is a strong requirement of a comprehensive system for integrative collection, storage, and analysis of data generated by this program. METHODS Data collection tools, questionnaires, instruments, and scales provided by the National Coordinating Unit were digitized using the District Health Information Software 2 (DHIS2) framework (version 2.30). The rules for data validation and automated scoring were implemented as per the scales. The developed system (i-MANN, ICMR-Mental Health Assessment National Network) is based on modular architecture with role-based access to data input forms and dashboards. RESULTS The data are stored on a centralized server at ICMR. i-MANN captures data on basic and advanced demographic details followed by category specific forms from 15 multicentric ICMR-funded projects. Data collection module is divided into 12 categories containing 93 scales/instruments with built-in validation rules, scoring patterns, and indicators. As of August 2020, the system contains 17,690 records. CONCLUSIONS i-MANN is the first web-based, modular, robust, and extendable system for collection, integration, management, and analysis of data on mental health in India.
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Affiliation(s)
- Jasmine Kaur
- Division of Biomedical Informatics (BMI), Indian Council of Medical Research, Ansari Nagar, New Delhi, Delhi, India
- Data Management Laboratory, Indian Council of Medical Research, New Delhi, Delhi, India
- School of Computational & Integrative Sciences, Jawaharlal Nehru University, New Delhi, Delhi, India
- Data Science Laboratory, Amity Institute of Integrative Science & Health, Amity University, Gurgaon, Haryana, India
| | - Vijay C Verma
- Division of Biomedical Informatics (BMI), Indian Council of Medical Research, Ansari Nagar, New Delhi, Delhi, India
- Data Management Laboratory, Indian Council of Medical Research, New Delhi, Delhi, India
| | - Vinit Kumar
- Division of Biomedical Informatics (BMI), Indian Council of Medical Research, Ansari Nagar, New Delhi, Delhi, India
- Data Management Laboratory, Indian Council of Medical Research, New Delhi, Delhi, India
| | - Ravinder Singh
- Division of Non-Communicable Diseases (NCD), Indian Council of Medical Research, New Delhi, Delhi, India
| | - Triptish Bhatia
- National Co-ordination Unit (NCU), Dept. of Psychiatry, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, Delhi, India
| | - Sushree Sahu
- National Co-ordination Unit (NCU), Dept. of Psychiatry, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, Delhi, India
| | - Madhur Manak
- Division of Biomedical Informatics (BMI), Indian Council of Medical Research, Ansari Nagar, New Delhi, Delhi, India
- Data Management Laboratory, Indian Council of Medical Research, New Delhi, Delhi, India
| | - Harish Kumar Buttolia
- Division of Biomedical Informatics (BMI), Indian Council of Medical Research, Ansari Nagar, New Delhi, Delhi, India
- Data Management Laboratory, Indian Council of Medical Research, New Delhi, Delhi, India
| | - Bhavik Choudhary
- Division of Biomedical Informatics (BMI), Indian Council of Medical Research, Ansari Nagar, New Delhi, Delhi, India
- Data Management Laboratory, Indian Council of Medical Research, New Delhi, Delhi, India
| | - Yogesh Singh Sharma
- Division of Biomedical Informatics (BMI), Indian Council of Medical Research, Ansari Nagar, New Delhi, Delhi, India
- Data Management Laboratory, Indian Council of Medical Research, New Delhi, Delhi, India
| | - Santosh Kumar Shah
- Division of Biomedical Informatics (BMI), Indian Council of Medical Research, Ansari Nagar, New Delhi, Delhi, India
- Data Management Laboratory, Indian Council of Medical Research, New Delhi, Delhi, India
| | - Prabhat Kumar
- Division of Biomedical Informatics (BMI), Indian Council of Medical Research, Ansari Nagar, New Delhi, Delhi, India
- Data Management Laboratory, Indian Council of Medical Research, New Delhi, Delhi, India
| | - Jasleen Kaur
- Division of Biomedical Informatics (BMI), Indian Council of Medical Research, Ansari Nagar, New Delhi, Delhi, India
- Data Management Laboratory, Indian Council of Medical Research, New Delhi, Delhi, India
| | - Smita Deshpande
- National Co-ordination Unit (NCU), Dept. of Psychiatry, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, Delhi, India
- Dept. of Psychiatry, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, Delhi, India
| | - Harpreet Singh
- Division of Biomedical Informatics (BMI), Indian Council of Medical Research, Ansari Nagar, New Delhi, Delhi, India
- Data Management Laboratory, Indian Council of Medical Research, New Delhi, Delhi, India
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Kumar CN, Chand PK, Manjunatha N, Math SB, Shashidhara HN, Basavaraju V, Thirthalli J, Manjappa AA, Parthasarathy R, Murthy P, Ibrahim FA, Jagtap N, Jyrwa S, Reddy S, Arora S, Hawk M, Kumar S, Egan J, Mcdonald M. Impact Evaluation of VKN-NIMHANS-ECHO Model of Capacity Building for Mental Health and Addiction: Methodology of Two Randomized Controlled Trials. Indian J Psychol Med 2020; 42:S80-S86. [PMID: 33487808 PMCID: PMC7802042 DOI: 10.1177/0253717620969066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Bridging the alarming treatment gap for mental disorders in India requires a monumental effort from all stakeholders. Harnessing digital technology is one of the potential ways to leapfrog many known barriers for capacity building. AIM AND CONTEXT The ongoing Virtual Knowledge Network (VKN)-National Institute of Mental Health and Neurosciences (NIMHANS)-Extension of Community Health Outcomes (ECHO) (VKN-NIMHANS-ECHO: hub and spokes model) model for skilled capacity building is a collaborative effort between NIMHANS and the University of New Mexico Health Sciences Centre, USA. This article aims to summarize the methodology of two randomized controlled trials funded by the Indian Council of Medical Research (ICMR) designed to evaluate the effectiveness of the VKN-NIMHANS-ECHO model of training as compared to training as usual (TAU). METHODS Both RCTs were conducted in Karnataka, a southern Indian state in which the DMHP operates in all districts. We compared the impact of the following two models of capacity building for the DMHP workforce (a) the VKN-NIMHANS-ECHO model and (b) the traditional method. We use the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement to describe the methods of these two trials.Trial 1 is to evaluate the "Effectiveness of addition of Virtual-NIMHANS-ECHO tele-mentoring model for skilled capacity building in providing quality care in alcohol use disorders by the existing staff of DMHP districts of Karnataka." Hub for trial 1 was set up at NIMHANS and the spokes were psychiatrists and other mental health professionals headquartered in the district level office. Trial 2 assesses the implementation and evaluation of the NIMHANS-ECHO blended training program for the DMHP workforce in a rural south-Indian district of Karnataka state. The hub for trial 2 was set up in the district headquarter of Ramanagaram. Hub specialists are DMHP psychiatrists, whereas spokes are the non-doctor workforce (including auxiliary nurse midwives [ANMs] and accredited social health activists [ASHA] workers) medical officers of primary health centers. The location of the HubHub differs in these two studies. Both trials are funded by the ICMR, Government of India. DISCUSSION Both these trials, though conceptually similar, have some operational differences which have been highlighted. If demonstrated to be effective, this model of telementoring can be generalized and widely merged into the Indian health care system, thus aiding in reducing the treatment gap for patients unable to access care.
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Affiliation(s)
| | - Prabhat Kumar Chand
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | | | - Vinay Basavaraju
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Jagadisha Thirthalli
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Adarsha Alur Manjappa
- Dept. of Health and Family Welfare Service, Government of Karnataka, Bengaluru, Karnataka, India
| | - Rajani Parthasarathy
- Dept. of Health and Family Welfare Service, Government of Karnataka, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Ferose Azeez Ibrahim
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Namrata Jagtap
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sonakshi Jyrwa
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Shanivaram Reddy
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sanjeev Arora
- The ECHO Institute, University of New Mexico, Albuquerque, NM, USA
| | - Mary Hawk
- Dept. of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
| | - Supriya Kumar
- Dept. of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
| | - James Egan
- Dept. of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
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139
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Rodriguez-Villa E, Naslund J, Keshavan M, Patel V, Torous J. Making mental health more accessible in light of COVID-19: Scalable digital health with digital navigators in low and middle-income countries. Asian J Psychiatr 2020; 54:102433. [PMID: 33271713 DOI: 10.1016/j.ajp.2020.102433] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 11/29/2022]
Abstract
The rapid spread of COVID-19 and the devastating consequences to economies and healthcare systems around the world has highlighted the exigent need for accessible mental health support. Increasing use of mobile devices in Lower Middle-Income Countries (LMIC) such as India offers novel opportunity to expand treatment options and reach underserved populations. Prior efforts have utilized technology to redistribute or supplement clinical care but measurable outcomes of this research are limited. In this paper, we explain the structural barriers that prevent access to care and build on prior research to demonstrate how technology can be utilized to offer treatment if it is aided by education and technical support.
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Affiliation(s)
- Elena Rodriguez-Villa
- Division of Digital Psychiatry at the Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - John Naslund
- Harvard Medical School and Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Matcheri Keshavan
- Division of Digital Psychiatry at the Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Vikram Patel
- Harvard Medical School and Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - John Torous
- Division of Digital Psychiatry at the Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
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140
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Banerjee D, Varshney P, Vajawat B. "Guarding the Gatekeepers": Suicides among Mental Health Professionals and Scope of Prevention, A Review. Psychiatry Res 2020; 294:113501. [PMID: 33065373 PMCID: PMC7543698 DOI: 10.1016/j.psychres.2020.113501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/03/2020] [Indexed: 12/02/2022]
Abstract
Suicide is a social evil that is considered to be a global epidemic. Mental healthcare professionals (MHP) (psychiatrists, clinical psychologists, psychiatric social work, etc.) are often involved as 'gatekeepers' in the management of suicidality and suicide prevention. Even though the risk of suicide in medical profession has received attention in research, there has been scarcity of literature related to the same in MHPs. They are not immune to the perils of psychological distress and its cascading consequences including suicide, contrary to the popular societal myths. The intrinsic and extrinsic pressures of the profession, persistent discourse in managing the psychological distress of others, professional burnout, self-stigma, societal apathy and easy access to psychotropics are certain factors making the MHPs more vulnerable. This disengagement and stress can contribute to depression, anxiety and complex trauma in the MHPs. The situation is furthermore compounded in developing countries with resource constraints, low MHP: patient ratio and inflexibility of work schedules. This makes tailored interventions, peer counselling, periodic mental health screenings and administrative understanding and accountability necessary at all levels. Keeping this in background, the review glances at the risk factors of suicide related to MHPs, highlights the problem statement and discusses the possible interventions.
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Affiliation(s)
- Debanjan Banerjee
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
| | - Prateek Varshney
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Bhavika Vajawat
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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141
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Singh SP, Khokhar A. Prevalence of Posttraumatic Stress Disorder and Depression in General Population in India During COVID-19 Pandemic Home Quarantine. Asia Pac J Public Health 2020; 33:154-156. [PMID: 33198479 DOI: 10.1177/1010539520968455] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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142
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Grover S, Sahoo S, Dua D, Mehra A, Nehra R. Psychological Impact of COVID-19 Duties During Lockdown on Police Personnel and Their Perception About the Behavior of the People: an Exploratory Study from India. Int J Ment Health Addict 2020; 20:831-842. [PMID: 33173448 PMCID: PMC7643718 DOI: 10.1007/s11469-020-00408-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2020] [Indexed: 11/29/2022] Open
Abstract
To evaluate the psychosocial issues among the police personnel during the COVID-19 pandemic. In a web-based cross-sectional survey, 623 police personnel were evaluated on Patient Health Questionnaire-4 (PHQ-4) and Perceived stress scale (PSS), and a self-designed questionnaire. 10.6% of the police personnel had significant anxiety and 18% have significant depressive symptoms with overall psychological morbidity of 22.2%. Higher age was significantly associated with higher depressive symptoms, total PHQ-4 score, and higher perceived stress. The present survey suggests that a substantial proportion of the police personnel on COVID-19 duty during the lockdown period have significant anxiety, depressive symptoms, and perceive significant stress. There is an urgent need to evaluate the mental health issues and provide psychological support to the police personnel who are considered as faceless warriors of the COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-020-00408-8.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Swapnajeet Sahoo
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Devakshi Dua
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aseem Mehra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritu Nehra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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143
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Pahuja E, Kumar TS, Uzzafar F, Manjunatha N, Kumar CN, Gupta R, Math SB. An impact of a digitally driven primary care psychiatry program on the integration of psychiatric care in the general practice of primary care doctors. Indian J Psychiatry 2020; 62:690-696. [PMID: 33896975 PMCID: PMC8052894 DOI: 10.4103/psychiatry.indianjpsychiatry_324_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 04/29/2020] [Accepted: 07/07/2020] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION The prevalence of psychiatric disorders among the general population is 10.6%. Primary care doctors (PCDs) are often the first contact for patients with common psychiatric disorders, but the majority of them are ill equipped to handle the same leading to symptomatic treatment. Hence, an innovative digitally driven and modular-based 1-year primary care psychiatry program (PCPP) was designed and implemented exclusively for practicing PCDs of Uttarakhand. AIM The aim of the study was to assess the impact of this digitally driven 1-year PCPP on the general practice of PCDs. MATERIALS AND METHODS Ten PCDs were trained in the curriculum module "Clinical Schedule for Primary Care Psychiatry" which is a validated concise guideline for screening, classification, diagnosis, treatment, follow-ups, and referrals. Furthermore, they underwent training in on-site basic module (10 days); three online modules (with nil or minimal disruption in their regular clinical work) - Telepsychiatric On-Consultation Training (Tele-OCT), Collaborative Video Consultations, and weekly virtual classroom; and one public health module. In addition, PCDs underwent 10 criteria-based formative assessment including self-reports of weekly patients' audit (Primary Care Psychiatry Quotient [PCPQ]) and quarterly Tele-OCT evaluation sessions (Translational Quotient [TQ]). RESULTS PCPQ was 11.09% (2182 psychiatric patients of total 19,670 general outpatients) which means 11.09% of PCDs' total general consultations had psychiatric disorders, which would have been otherwise missed. Average scores obtained in first and second Tele-OCT evaluations (similar to clinical examination but in their real-time consultation) were 70.33% and 76.33%, respectively, suggestive of adequate TQ at 6 and 9 months of the course. CONCLUSIONS One-year PCPP is shown to be effective in acquiring psychiatry knowledge, skills, and retention of skills (TQ) and also translated in providing psychiatric care in general practice with a positive impact on the delivery of primary care psychiatry.
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Affiliation(s)
- Erika Pahuja
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Thamaraiselvan Santhosh Kumar
- Department of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Fareed Uzzafar
- Department of Medical Health and Family Welfare, National Health Mission, Government of Uttarakhand, Dehradun, Uttarakhand, India
| | - Narayana Manjunatha
- Department of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Channaveerachari Naveen Kumar
- Department of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ravi Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Suresh Bada Math
- Department of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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144
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Krishnamoorthy Y, Rehman T, Eliyas SK. Age-Period-Cohort Analysis of Trends in Mental Health Mortality in India from 2001 to 2015. Community Ment Health J 2020; 56:1566-1570. [PMID: 32166708 DOI: 10.1007/s10597-020-00608-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
Abstract
The current study was done to examine the trend of mental health mortality in India using age-period-cohort (APC) analysis. We have conducted a secondary data analysis by using the data on mental health mortality from WHO Global Health Estimates. We performed APC analysis by weighted least squares regression with assumption that data follows Poisson distribution.Annual increase in the age adjusted mortality rate due to mental health problems was 1.52%. Rate ratio (RR) increased consistently across all the age groups from 15-19 to 80-84 years. RR of period effects also showed increase from 2001-2005 to 2011-2015 periods. RR of cohort effects showed consistent increase from 1921-1925 to 1986-1990 cohorts and then decreasing from 1991-1995 to 1996-2000. To summarize, we found that mental health mortality shows increasing trend in India over the past decade with maximum increase among older population.
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Affiliation(s)
- Yuvaraj Krishnamoorthy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605008, India.
| | - Tanveer Rehman
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605008, India
| | - Salin K Eliyas
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605008, India
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145
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Padmavati R, Raghavan V, Rera H, Kearns M, Rao K, John S, Thara R. Learnings from conducting mental health research during 2004 tsunami in Tamil Nadu, India. BMC Public Health 2020; 20:1627. [PMID: 33121446 PMCID: PMC7594993 DOI: 10.1186/s12889-020-09733-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/20/2020] [Indexed: 11/18/2022] Open
Abstract
Background The Indian Ocean tsunami experience in 2004 caused a major loss of life and subsequent emotional trauma for survivors. Psychosocial needs in the aftermath of this disaster were extensive, yet the cohesion and effectiveness of response were limited due to lack of preparedness and relevant policy. The Schizophrenia Research Foundation (SCARF) was one of the organizations that quickly responded to provide psychosocial assistance to people in the tsunami affected areas and recognized a need for relevant research on disaster response. Therefore, we undertook research on the challenges, success and limitations of psychosocial interventions in alleviating post-traumatic symptomology. Discussion Both community-level workers and researchers were limited in their preparedness to carry out tasks related to response. Language barriers, cultural differences, and a gap in long-term services limited the breadth and scope of research that was able to be completed. Lack of policy, poor co-ordination of services, lack of trained researchers and limited resources were challenges that emerged during this period and various strategies were adopted to meet these challenges. Conclusions Continued research and evaluation of data has brought crucial considerations to light, including the variance in symptomology, effective tools of measurement, and the nuanced response of survivors. Future research should take relevant factors into consideration including barriers to care. Understanding of the local language and religious beliefs are significant resources in understanding the nature of survivors’ trauma response and effective means of coping. Lastly, limitations regarding time frame and scope of research should be evaluated to provide more effective, comprehensive methods in future studies.
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Affiliation(s)
- R Padmavati
- Schizophrenia Research Foundation, R/7A, North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600101, India.
| | - Vijaya Raghavan
- Schizophrenia Research Foundation, R/7A, North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600101, India
| | - Heather Rera
- Schizophrenia Research Foundation, R/7A, North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600101, India
| | - Megan Kearns
- Schizophrenia Research Foundation, R/7A, North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600101, India
| | - Kotteeswara Rao
- Schizophrenia Research Foundation, R/7A, North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600101, India
| | - Sujit John
- Schizophrenia Research Foundation, R/7A, North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600101, India
| | - R Thara
- Schizophrenia Research Foundation, R/7A, North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600101, India
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146
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Nemlekar S, Gaonkar P, Rane A. Domiciliary alcohol detoxification outcomes: a study from Goa, India. J Addict Dis 2020; 39:105-108. [PMID: 33079007 DOI: 10.1080/10550887.2020.1826103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Alcohol use disorder (AUD) is a significant public health problem across all regions of the world. Overall evidence regarding outcomes is available from western regions. Detoxification is one of the first steps in treating AUDs. The following case note review looks at community detoxification outcomes in a naturalistic setting. We looked at 100 clients with domiciliary detoxification. We found only 35% had a favorable outcome (follow up as advised) while 65% had unfavorable outcomes (lost to follow up or required admission). Trends of higher alcohol use (units/day) were seen in the unfavorable group. We also found that having a medical co-morbidity was associated with unfavorable outcome. In resource poor setting like our country there is a need to look at ways to enhance home detoxification programs; use of technology and supervised monitoring could probably improve the outcomes.
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Affiliation(s)
| | - Pooja Gaonkar
- General Practitioner, DHA Fitness Centre, HHC, Dubai, UAE
| | - Anil Rane
- Lecturer, Institute of Psychiatry and Human Behavior, Goa, India
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147
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Kumar K, Mehra A, Sahoo S, Nehra R, Grover S. The psychological impact of COVID-19 pandemic and lockdown on the migrant workers: A cross-sectional survey. Asian J Psychiatr 2020; 53:102252. [PMID: 32593970 PMCID: PMC7305726 DOI: 10.1016/j.ajp.2020.102252] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Krishan Kumar
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aseem Mehra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Swapnajeet Sahoo
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritu Nehra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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148
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Dahal S, Dhimal M, Pant SB, Sharma P, Marahatta K, Luitel N, Shakya S, Labh S, Ojha SP, Jha AK, Sheehan DV. Pilot Mental Health Survey, Nepal: Lessons Learned for Survey Design and Instrumentation. INNOVATIONS IN CLINICAL NEUROSCIENCE 2020; 17:17-23. [PMID: 33898097 PMCID: PMC7819577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Objective: Learning from pilot studies is crucial for the successful implementation of large-scale surveys. In this manuscript, we present the lessons learned for instrumentation and survey methods from a pilot national mental health survey conducted in Nepal. Design: We conducted a cross-sectional study among 1,647 participants aged 13 years and older in three districts of Nepal. We used the Nepali translated standard adult and adolescent versions of the Mini International Neuropsychiatric Interview (MINI) 7.0.2 for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) to do face-to-face structured diagnostic interviews. In addition, we included questionnaires on help-seeking behavior and barriers in accessing care. Results: We used a six-step procedure to translate and fit the tools in the context of Nepal. We conducted pretesting to evaluate the Nepali translated tools and adaptations, such as the addition of bridging sentences at the start of different modules. We identified different challenges during the tools administration and the ways to minimize reporting bias during data collection. Conclusion: The pilot survey identified the areas for improvement in survey tools, techniques, and methodology. The lessons learned from the pilot survey and the resulting corrective recommendations helped in more successful implementation of the Nepal national mental health survey.
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Affiliation(s)
- Sushma Dahal
- Drs. Dhimal and Jha and Ms. Dahal and Ms. Labh are with the Nepal Health Research Council in Kathmandu, Nepal, and are members of the Technical Working Group, National Mental Health Survey, in Nepal
- Drs. Pant, Shakya, and Ojha are members of the Technical Working Group, National Mental Health Survey, in Nepal and are with the Department of Psychiatry and Mental Health, Institute of Medicine at Tribhuvan University in Kathmandu, Nepal
- Dr. Sharma is a member of the Technical Working Group, National Mental Health Survey, in Nepal and with the Patan Academy of Health Sciences in Lalitpur, Nepal
- Dr. Marahatta is a member of the Technical Working Group, National Mental Health Survey, in Nepal. Mr. Luitel is a member of the Technical Working Group, National Mental Health Survey, in Nepal and is with the Transcultural Psychosocial Organization Nepal in Kathmandu, Nepal
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
| | - Meghnath Dhimal
- Drs. Dhimal and Jha and Ms. Dahal and Ms. Labh are with the Nepal Health Research Council in Kathmandu, Nepal, and are members of the Technical Working Group, National Mental Health Survey, in Nepal
- Drs. Pant, Shakya, and Ojha are members of the Technical Working Group, National Mental Health Survey, in Nepal and are with the Department of Psychiatry and Mental Health, Institute of Medicine at Tribhuvan University in Kathmandu, Nepal
- Dr. Sharma is a member of the Technical Working Group, National Mental Health Survey, in Nepal and with the Patan Academy of Health Sciences in Lalitpur, Nepal
- Dr. Marahatta is a member of the Technical Working Group, National Mental Health Survey, in Nepal. Mr. Luitel is a member of the Technical Working Group, National Mental Health Survey, in Nepal and is with the Transcultural Psychosocial Organization Nepal in Kathmandu, Nepal
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
| | - Sagun Ballav Pant
- Drs. Dhimal and Jha and Ms. Dahal and Ms. Labh are with the Nepal Health Research Council in Kathmandu, Nepal, and are members of the Technical Working Group, National Mental Health Survey, in Nepal
- Drs. Pant, Shakya, and Ojha are members of the Technical Working Group, National Mental Health Survey, in Nepal and are with the Department of Psychiatry and Mental Health, Institute of Medicine at Tribhuvan University in Kathmandu, Nepal
- Dr. Sharma is a member of the Technical Working Group, National Mental Health Survey, in Nepal and with the Patan Academy of Health Sciences in Lalitpur, Nepal
- Dr. Marahatta is a member of the Technical Working Group, National Mental Health Survey, in Nepal. Mr. Luitel is a member of the Technical Working Group, National Mental Health Survey, in Nepal and is with the Transcultural Psychosocial Organization Nepal in Kathmandu, Nepal
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
| | - Pawan Sharma
- Drs. Dhimal and Jha and Ms. Dahal and Ms. Labh are with the Nepal Health Research Council in Kathmandu, Nepal, and are members of the Technical Working Group, National Mental Health Survey, in Nepal
- Drs. Pant, Shakya, and Ojha are members of the Technical Working Group, National Mental Health Survey, in Nepal and are with the Department of Psychiatry and Mental Health, Institute of Medicine at Tribhuvan University in Kathmandu, Nepal
- Dr. Sharma is a member of the Technical Working Group, National Mental Health Survey, in Nepal and with the Patan Academy of Health Sciences in Lalitpur, Nepal
- Dr. Marahatta is a member of the Technical Working Group, National Mental Health Survey, in Nepal. Mr. Luitel is a member of the Technical Working Group, National Mental Health Survey, in Nepal and is with the Transcultural Psychosocial Organization Nepal in Kathmandu, Nepal
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
| | - Kedar Marahatta
- Drs. Dhimal and Jha and Ms. Dahal and Ms. Labh are with the Nepal Health Research Council in Kathmandu, Nepal, and are members of the Technical Working Group, National Mental Health Survey, in Nepal
- Drs. Pant, Shakya, and Ojha are members of the Technical Working Group, National Mental Health Survey, in Nepal and are with the Department of Psychiatry and Mental Health, Institute of Medicine at Tribhuvan University in Kathmandu, Nepal
- Dr. Sharma is a member of the Technical Working Group, National Mental Health Survey, in Nepal and with the Patan Academy of Health Sciences in Lalitpur, Nepal
- Dr. Marahatta is a member of the Technical Working Group, National Mental Health Survey, in Nepal. Mr. Luitel is a member of the Technical Working Group, National Mental Health Survey, in Nepal and is with the Transcultural Psychosocial Organization Nepal in Kathmandu, Nepal
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
| | - Nagendra Luitel
- Drs. Dhimal and Jha and Ms. Dahal and Ms. Labh are with the Nepal Health Research Council in Kathmandu, Nepal, and are members of the Technical Working Group, National Mental Health Survey, in Nepal
- Drs. Pant, Shakya, and Ojha are members of the Technical Working Group, National Mental Health Survey, in Nepal and are with the Department of Psychiatry and Mental Health, Institute of Medicine at Tribhuvan University in Kathmandu, Nepal
- Dr. Sharma is a member of the Technical Working Group, National Mental Health Survey, in Nepal and with the Patan Academy of Health Sciences in Lalitpur, Nepal
- Dr. Marahatta is a member of the Technical Working Group, National Mental Health Survey, in Nepal. Mr. Luitel is a member of the Technical Working Group, National Mental Health Survey, in Nepal and is with the Transcultural Psychosocial Organization Nepal in Kathmandu, Nepal
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
| | - Suraj Shakya
- Drs. Dhimal and Jha and Ms. Dahal and Ms. Labh are with the Nepal Health Research Council in Kathmandu, Nepal, and are members of the Technical Working Group, National Mental Health Survey, in Nepal
- Drs. Pant, Shakya, and Ojha are members of the Technical Working Group, National Mental Health Survey, in Nepal and are with the Department of Psychiatry and Mental Health, Institute of Medicine at Tribhuvan University in Kathmandu, Nepal
- Dr. Sharma is a member of the Technical Working Group, National Mental Health Survey, in Nepal and with the Patan Academy of Health Sciences in Lalitpur, Nepal
- Dr. Marahatta is a member of the Technical Working Group, National Mental Health Survey, in Nepal. Mr. Luitel is a member of the Technical Working Group, National Mental Health Survey, in Nepal and is with the Transcultural Psychosocial Organization Nepal in Kathmandu, Nepal
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
| | - Sweta Labh
- Drs. Dhimal and Jha and Ms. Dahal and Ms. Labh are with the Nepal Health Research Council in Kathmandu, Nepal, and are members of the Technical Working Group, National Mental Health Survey, in Nepal
- Drs. Pant, Shakya, and Ojha are members of the Technical Working Group, National Mental Health Survey, in Nepal and are with the Department of Psychiatry and Mental Health, Institute of Medicine at Tribhuvan University in Kathmandu, Nepal
- Dr. Sharma is a member of the Technical Working Group, National Mental Health Survey, in Nepal and with the Patan Academy of Health Sciences in Lalitpur, Nepal
- Dr. Marahatta is a member of the Technical Working Group, National Mental Health Survey, in Nepal. Mr. Luitel is a member of the Technical Working Group, National Mental Health Survey, in Nepal and is with the Transcultural Psychosocial Organization Nepal in Kathmandu, Nepal
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
| | - Saroj Prasad Ojha
- Drs. Dhimal and Jha and Ms. Dahal and Ms. Labh are with the Nepal Health Research Council in Kathmandu, Nepal, and are members of the Technical Working Group, National Mental Health Survey, in Nepal
- Drs. Pant, Shakya, and Ojha are members of the Technical Working Group, National Mental Health Survey, in Nepal and are with the Department of Psychiatry and Mental Health, Institute of Medicine at Tribhuvan University in Kathmandu, Nepal
- Dr. Sharma is a member of the Technical Working Group, National Mental Health Survey, in Nepal and with the Patan Academy of Health Sciences in Lalitpur, Nepal
- Dr. Marahatta is a member of the Technical Working Group, National Mental Health Survey, in Nepal. Mr. Luitel is a member of the Technical Working Group, National Mental Health Survey, in Nepal and is with the Transcultural Psychosocial Organization Nepal in Kathmandu, Nepal
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
| | - Anjani Kumar Jha
- Drs. Dhimal and Jha and Ms. Dahal and Ms. Labh are with the Nepal Health Research Council in Kathmandu, Nepal, and are members of the Technical Working Group, National Mental Health Survey, in Nepal
- Drs. Pant, Shakya, and Ojha are members of the Technical Working Group, National Mental Health Survey, in Nepal and are with the Department of Psychiatry and Mental Health, Institute of Medicine at Tribhuvan University in Kathmandu, Nepal
- Dr. Sharma is a member of the Technical Working Group, National Mental Health Survey, in Nepal and with the Patan Academy of Health Sciences in Lalitpur, Nepal
- Dr. Marahatta is a member of the Technical Working Group, National Mental Health Survey, in Nepal. Mr. Luitel is a member of the Technical Working Group, National Mental Health Survey, in Nepal and is with the Transcultural Psychosocial Organization Nepal in Kathmandu, Nepal
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
| | - David V Sheehan
- Drs. Dhimal and Jha and Ms. Dahal and Ms. Labh are with the Nepal Health Research Council in Kathmandu, Nepal, and are members of the Technical Working Group, National Mental Health Survey, in Nepal
- Drs. Pant, Shakya, and Ojha are members of the Technical Working Group, National Mental Health Survey, in Nepal and are with the Department of Psychiatry and Mental Health, Institute of Medicine at Tribhuvan University in Kathmandu, Nepal
- Dr. Sharma is a member of the Technical Working Group, National Mental Health Survey, in Nepal and with the Patan Academy of Health Sciences in Lalitpur, Nepal
- Dr. Marahatta is a member of the Technical Working Group, National Mental Health Survey, in Nepal. Mr. Luitel is a member of the Technical Working Group, National Mental Health Survey, in Nepal and is with the Transcultural Psychosocial Organization Nepal in Kathmandu, Nepal
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
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149
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Ghosh A, Verma M, Lal S. A Review of Models and Efficacy of Telepsychiatry for Inpatient Service Delivery: Proposing a Model for Indian Settings. Indian J Psychol Med 2020; 42:34S-40S. [PMID: 33354061 PMCID: PMC7736746 DOI: 10.1177/0253717620958168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The use of telepsychiatry (TP) for inpatient service delivery is still an emerging field and there is limited literature on its practice and evidence. This review was conducted with the objectives of (a) exploring the models of TP for inpatient service delivery, (b) qualitative synthesis of the efficacy of TP in inpatient settings, and (c) proposing a best-fit model of TP-based inpatient care for Indian settings. METHODS An electronic database search was conducted on July 22, 2020, in PubMed, Directory of Open Access Journals, and Google Scholar for relevant articles. Seventeen articles were included in the review. RESULTS The review revealed three models for TP-based inpatient care; direct care model, teleconsultation model, and the collaborative care model. Preliminary evidence suggests that TP is cost-effective and reliable, and that patients and service providers are highly satisfied with this approach. Evidence gaps were seen for some diagnostic categories such as psychosis and for extremes of age groups. Based on the existing models, we propose an Indian model for implementing TP in inpatient settings. CONCLUSION Promising initial results and the evidence gaps highlight the need for further research in this area.
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Affiliation(s)
- Abhishek Ghosh
- Dept. of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Meha Verma
- Dept. of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shalini Lal
- School of Rehabilitation, University of Montreal, Montreal, QC, Canada.,Youth Mental Health and Technology Lab, University of Montreal Hospital Research Centre, Montreal, QC, Canada.,PEPP Montreal and ACCESS Open Minds, Douglas Mental Health University Institute, Montreal, QC, Canada
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150
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Chenniappan R, Nandeesha H, Kattimani S, Nanjaiah ND. Interleukin-17 and Interleukin-10 Association with Disease Progression in Schizophrenia. Ann Neurosci 2020; 27:24-28. [PMID: 32982096 DOI: 10.1177/0972753120929565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Alteration in cytokine levels are known to be involved in the pathogenesis of schizophrenia. OBJECTIVES To estimate the serum levels of interleukin-17 (IL-17) and interleukin-10 (IL-10) and their association with disease progression in schizophrenia. METHODS A total of 67 schizophrenia cases were enrolled in the present study. IL-17 and IL-10 were estimated by enzyme-linked immunosorbent assay. Positive and Negative Syndrome Scale (PANSS) was used to evaluate disease severity. RESULTS IL-17 was positively correlated with positive symptom score (r = 0.256, p = .036), general psychopathology score (r = 0.255, p = .038) and total score (r = 0.273, p = .025) in schizophrenia. IL-17 and IL-10 were significantly increased in schizophrenia cases with PANSS more than 85 compared to those with 71-85. CONCLUSION IL-17 and IL-10 are associated with disease severity in schizophrenia but are not good markers for predicting the disease progression.
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Affiliation(s)
- Raghavi Chenniappan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Hanumanthappa Nandeesha
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shivanand Kattimani
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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