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Bashar MDA, Mehra A, Aggarwal AK. Prevalence and sociodemographic determinants of common mental disorders (CMDs) symptoms in a rural adult population of Haryana, North India. J Rural Med 2024; 19:49-56. [PMID: 38655225 PMCID: PMC11033676 DOI: 10.2185/jrm.2023-013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 11/13/2023] [Indexed: 04/26/2024] Open
Abstract
Objectives Common mental disorders (CMDs), including depression, anxiety, and somatoform disorders, affect all stages of life and impact individuals, families, and communities. This study aimed to determine the magnitude of CMDs and their sociodemographic determinants in the adult population of a rural block in North India. Material and Methods A cross-sectional, quantitative, community-based study was conducted among adult residents of a rural block in Haryana, North India, using a multistage random sampling technique. The Hindi version of the General Health Questionnaire (GHQ-12), a well-validated tool, was used to screen participants for CMDs. Scores of 4 or above denoted the presence of CMDs. Bivariate analyses were performed to determine the associations between CMDs and sociodemographic characteristics. Results Of the 180 residents selected for the study, most were women (60.0%) and aged between 31 and 50 years (52.3%). The prevalence of CMDs symptoms in the study population was 20.0%. The presence of CMDs symptoms was significantly higher among those who were aged 60 years or older [OR=12.33, 95% CI 3.21-47.38], widowed, divorced or separated [OR=7.50, 95% CI 1.09-51.52], illiterate [OR= 6.25, 95% CI 2.84-13.77], had monthly family income below 10,000 INR [OR=3.33, 95% CI 1.54-7.20], had any chronic physical illness [OR=8.28, 95% CI 3.70-18.56] and had a family history of any psychiatric illness [OR=5.56, 95% CI 1.52-19.42]. Conclusion The burden of CMDs was quite high among adults in rural North India. The presence of CMDs was closely associated with sociodemographic characteristics. Primary care and community-based settings need to screen for, diagnose, and manage CMDs to address this growing problem.
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Affiliation(s)
- MD. Abu Bashar
- Department of Community & Family Medicine, All India
Institute of Medical Sciences (AIIMS), India
| | - Aseem Mehra
- Department of Psychiatry, Postgraduate Institute of Medical
Education and Research (PGIMER), India
| | - Arun Kumar Aggarwal
- Department of Community Medicine, Postgraduate Institute of
Medical Education and Research (PGIMER), India
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Srivastava K, Chatterjee K, Prakash J, Yadav A, Chaudhury S. Comparative efficacy of cognitive behavior therapy and interpersonal therapy in the treatment of depression: A randomized controlled study. Ind Psychiatry J 2024; 33:160-167. [PMID: 38853783 PMCID: PMC11155630 DOI: 10.4103/ipj.ipj_294_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/18/2023] [Accepted: 10/22/2023] [Indexed: 06/11/2024] Open
Abstract
Background Depressive disorders are one of the most common psychiatric disorders that occur in people of all ages. Aim To assess the efficacy of cognitive behavior therapy (CBT) and interpersonal therapy (IPT) in cases of depression. Materials and Methods The sample for the study comprised 52 diagnosed cases of major depressive disorder (MDD) based on the 10th revision of the International Classification of Diseases (ICD-10) criteria in the age range of 21 to 50 years. They were randomized with the help of the app and assigned to CBT and IPT groups. Two patients had dropped out of the CBT group. Hence, finally, 50 cases were taken for study. A total of 12 therapy sessions were given. All patients were given standard treatment as prescribed. Results Findings of paired samples t-test to assess the within-group differences in both the groups (CBT and IPT) as well as gains score statistics or difference score statistics (pre-test minus post-test) were applied to compare group differences. Results of paired samples 't' test suggest that there was a statistically significant difference in the scores of both the groups from pre-test to post-test. IPT group had shown significantly better outcomes as quantified by the percentage of patients scoring less on the outcome variable of the Beck Depression Inventory (BDI), Montgomery-Asberg Depression Rating Scale (MADRS), Hopelessness Scale, and General Health Questionnaire (GHQ). Conclusion Both CBT and IPT are efficacious in the treatment of MDD. IPT yielded better results on MADRS as compared to CBT on parameters of outcome in the present study. The findings indicate that interventions were effective in reducing the symptoms of depression.
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Affiliation(s)
- Kalpana Srivastava
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Kaushik Chatterjee
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Jyoti Prakash
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Arun Yadav
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr D Y Patil Medical College, Dr D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
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Kumar SGP, Ranpise D, Chavan S, Vishwakarma P, Krishnan R, Kurian E. Depressive and generalized anxiety symptoms in adults awaiting cataract surgery in India. THE NATIONAL MEDICAL JOURNAL OF INDIA 2023; 35:348-356. [PMID: 37167512 DOI: 10.25259/nmji_35_6_348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Background Systematic data on mental health issues among adults awaiting cataract treatment are not readily available in India. We explored the prevalence and predictors of depressive and generalized anxiety (GA) symptoms in a cohort of adults awaiting cataract surgery. Methods Our study is based on data from baseline assessments which were conducted as part of a multicentre prospective, longitudinal cohort study. Subjects were recruited from four eye hospitals to assess depression and GA and associated risk factors using standardized scales, i.e. Center for Epidemiologic Studies-Depression Scale (CES-D) and Generalised Anxiety Disorder (GAD-7). Variation in the intensity of depression and GA was assessed using multiple classification analysis (MCA). Results A total of 813 adults awaiting cataract surgery participated, of whom 456 (56.1%) were men. The mean (SD) CES-D and GAD-7 scores were 24.6 (7.8) and 6.3 (SD 4.2) for men and 25.8 (8.9) and 6.9 (4.4) for women, respectively. The overall prevalence of depression score of >16 was 87.4% (95% confidence interval [CI] 84.7%- 89.6%), and GA score of >10 was 57.1% (95% CI 53.5%-60.7%). The prevalence of comorbid depressive and anxiety symptoms was 56.6% (95% CI 52.9%- 60.2%). MCA showed that being neglected and mistreated by family/friends because of vision condition and facing difficulty and requiring help with daily tasks had the highest effect on the intensity of both depression (beta=0.254 and 0.238, respectively) and GA (beta=0.219 and 0.211, respectively). Conclusion The majority of adults with untreated cataract had both depressive and GA symptoms. These findings could be used for planning mental health interventions for adults awaiting cataract surgery.
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Affiliation(s)
- S G Prem Kumar
- Mission for Vision, Office 45, Maker Chamber VI, 220 Jamnalal, Bajaj Marg, Nariman Point, Mumbai 400021, Maharashtra, India
| | - Dhanaji Ranpise
- Mission for Vision, Office 45, Maker Chamber VI, 220 Jamnalal, Bajaj Marg, Nariman Point, Mumbai 400021, Maharashtra, India
| | - Shobhana Chavan
- Mission for Vision, Office 45, Maker Chamber VI, 220 Jamnalal, Bajaj Marg, Nariman Point, Mumbai 400021, Maharashtra, India
| | - Pankaj Vishwakarma
- Mission for Vision, Office 45, Maker Chamber VI, 220 Jamnalal, Bajaj Marg, Nariman Point, Mumbai 400021, Maharashtra, India
| | - Radhika Krishnan
- Aditya Jyot Foundation for Twinkling Little Eyes, Mumbai, Maharashtra, India
| | - Elizabeth Kurian
- Mission for Vision, Office 45, Maker Chamber VI, 220 Jamnalal, Bajaj Marg, Nariman Point, Mumbai 400021, Maharashtra, India
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Ram D, Bheemaraju SP, Alammar MA. Explanatory Models and their Relationship with Drug Attitude in Patients with Depression in South India. Indian J Psychol Med 2023; 45:53-58. [PMID: 36778620 PMCID: PMC9896122 DOI: 10.1177/02537176221098329] [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: 11/17/2022] Open
Abstract
BACKGROUND The patient's understanding of the illness may mediate beliefs towards its treatment. There is a paucity of studies examining the relationships between these variables in depression. This study was conducted to know the relationships between explanatory models and attitude to medication in depression. METHODS 494 patients with depression in remission were assessed with sociodemographic proforma, Drug Attitude Inventory, and Mental Distress Explanatory Model Questionnaire. RESULTS A favorable attitude toward medication was observed in 57.49% of participants. Mean scores on MDEMQ subscales Stress, Western Physiology, Non-Western Physiology, and Supernatural were 32.96, 21.87, 10.06, and 47.55, respectively. Statistically significant associations were found between attitude towards medication and the patient's marital status (more negative attitude with single status, χ2 = 11.72, df = 3, P = 0.008) and occupation (more negative attitude among unemployed patients, χ2 = 4.17, df = 1, P = 0.041). The scores of explanatory models did not differ based on positive or negative drug attitude. CONCLUSION Though explanatory models are not linked to patient attitudes toward medication, patients who are single or unemployed have a negative attitude toward medications. Such negative attitude may impair compliance and worsen patient outcomes.
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Affiliation(s)
- Dushad Ram
- Dept. of Medicine(Psychiatry), College of Medicine, Shaqra University, Shaqra, Riyadh Province, Saudi Arabia
| | | | - Muath A Alammar
- Dept. of Medicine (Family Medicine), Shaqra College of Medicine, Shaqra University, Shaqra, Riyadh Province, Saudi Arabia
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Wasil AR, Malhotra T, Nandakumar N, Glinski S, Bhatia A, DeRubeis RJ. Which Symptoms of Depression and Anxiety Matter Most? An Investigation of Subjective Importance Ratings With College Students in India. Behav Ther 2022; 53:958-966. [PMID: 35987551 DOI: 10.1016/j.beth.2022.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/28/2022] [Accepted: 04/02/2022] [Indexed: 12/21/2022]
Abstract
One goal of clinical psychological science is to help people with problems that matter to them. However, little is known about which kinds of symptoms are viewed as most important, particularly among individuals in non-western settings. We examined the extent to which young adults in India rated individual symptoms of depression and anxiety as important, concerning, and undesirable. Participants were college students at Indian Universities (n = 283). They received a measure of depressive symptoms (Patient Health Questionnaire-9) and anxiety symptoms (Generalized Anxiety Disorder Screener-7). For each of the 16 symptoms, they provided three judgments relating to the extent to which they found the symptom important, harmful, and undesirable. These judgments were averaged to form a "subjective importance rating" (SIR) for each symptom. Anxiety symptoms were viewed as more important than depressive symptoms (d = 0.34), and nonsomatic symptoms were viewed as more important than somatic symptoms (d = 0.83). Females rated symptoms as more important than males (d = 0.32), and individuals with higher self-reported symptoms rated symptoms as more important. Sad mood, suicidal ideation, and controlling worries were rated as the most important symptoms, whereas concentration problems, appetite problems, and psychomotor problems were rated as the least important. Overall, some symptoms are viewed as more important and concerning than others. We discuss how this understanding can affect our conceptualization, assessment, and treatment of mental disorders around the world.
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The role of religiosity and religious participation in the relationship between depressive symptoms and cognitive impairment among older Indian adults. Sci Rep 2022; 12:11915. [PMID: 35831311 PMCID: PMC9279482 DOI: 10.1038/s41598-022-14744-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/13/2022] [Indexed: 02/04/2023] Open
Abstract
Due to different nature of social engagements of older adults in South Asian countries specially attributed to the traditional family-based care and support, beneficial effects of religiosity and religious involvement on mental health and cognitive function in older age might be different than those in the Western world. Yet, there is a paucity of research in these countries on the role of religion in moderating the relationship between late life depression and cognition. This study explored the association of depressive symptoms with cognitive impairment and the moderating effects of religiosity and religious participation in those associations among older Indian adults. A cross-sectional study was conducted on data that were drawn from the Longitudinal Ageing Study in India wave-1, collected during 2017-2018. The sample size comprised of 31,464 older adults aged 60 years and above. Shortened 10-item Centre for Epidemiologic Studies Depression Scale was used to measure depressive symptoms. Items from the Mini-Mental State Examination and the cognitive module of the China Health and Retirement Longitudinal Study and the Mexican Health and Aging Study were adapted for measuring cognitive impairment. Moderated multiple linear regression models were used to test the research hypotheses of the study. The proportion of older adults who reported religion as less important to them was 21.24%, whereas, only 19.31% of the respondents participated in religious activities. The mean score of cognitive impairment (on a scale of 0-43) in the current sample was 19.43 [confidence interval (CI): 19.32-19.53] among men and 23.55 [CI: 23.44-23.66] among women. Older adults with depressive symptoms had significantly higher likelihood of cognitive impairment [aCoef: 0.18, CI: 0.16-0.20] in comparison to older adults with no depressive symptoms. Older individuals who were religious were significantly less likely to have cognitive impairment [aCoef: - 0.43, CI: - 0.61 to - 0.25] than their non-religious counterparts. Compared to older adults who did not participate in religious activities, those who participated in religious activities were less likely [aCoef: - 0.52, CI: - 0.69 to - 0.34] to have cognitive impairment. Further, significant moderating effects of religiosity and religious participation in the relationship between depressive symptoms and cognitive impairment were observed. The current study contributes to advancing knowledge about the mental health benefits of religiosity and religious participation by focusing on older adults in India who culturally have limited chances to participate in social activities. The findings suggest that older adults with depressive symptoms may participate in religious activities which may reduce their chances of cognitive impairment. This protective effect of religiosity and religious participation on late life cognitive health has important implications for promoting alternative social support mechanisms for older adults in terms of enhancing their mental wellbeing and contributing to active aging.
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Ramesh V, Venkatesan V, Ramasamy B. Role of serotonin transporter and receptor gene polymorphisms in treatment response to selective serotonin reuptake inhibitors in major depressive disorder. Hum Psychopharmacol 2022; 37:e2830. [PMID: 34994008 DOI: 10.1002/hup.2830] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/28/2021] [Accepted: 12/10/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Significant challenges in the management of major depressive disorder include the lag period from treatment initiation to an evident response, low response rates and unpredictable disparities in outcome between patients. As a large part of these has been linked to genetic mechanisms, we tried to establish a relationship between genes associated with serotonin neurotransmission and outcome to selective serotonin reuptake inhibitor (SSRI) treatment. METHODS One hundred and twenty-five patients with moderate to severe depression [at least 15 on the Hamilton Depression (HAM-D) Rating Scale] being started on SSRI were recruited. Those with a reduction of at least 50% from baseline or an absolute score of 7 or less after 8 weeks of treatment were considered as responders. The serotonin transporter linked polymorphic region 5HTTLPR, serotonin transporter intron 2 (STin2) polymorphism and the 5-HT receptor 1A rs6295 polymorphisms were studied in association with outcome. RESULTS The l/l genotype of the 5HTTLPR was associated with greater likelihood of response (OR: 4.65, CI: 1.74-12.38, p = 0.003). Patients with the 12/12 repeat variant of the STin2 VNTR polymorphism showed a greater reduction in HAM-D score, compared to patients with the 10/10 genotype (OR: 0.12, CI: 0.03-0.44, p = 0.001). We found no association of the 5HTR1Ars6295 polymorphism with response. CONCLUSIONS The 5HTTLPR polymorphism and the SLC6A4 intron 2 polymorphism were associated with treatment response, with the l/l genotype and 12-copy allele showing a tendency towards better outcomes, respectively.
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Affiliation(s)
- Varsha Ramesh
- Department of Pharmacology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Vettriselvi Venkatesan
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Balakrishnan Ramasamy
- Department of Psychiatry, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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Plumbagin Alleviates Intracerebroventricular-Quinolinic Acid Induced Depression-like Behavior and Memory Deficits in Wistar Rats. Molecules 2022; 27:molecules27061834. [PMID: 35335195 PMCID: PMC8955906 DOI: 10.3390/molecules27061834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 02/01/2023] Open
Abstract
Plumbagin, a hydroxy-1,4-naphthoquinone, confers neuroprotection via antioxidant and anti-inflammatory properties. The present study aimed to assess the effect of plumbagin on behavioral and memory deficits induced by intrahippocampal administration of Quinolinic acid (QA) in male Wistar rats and reveal the associated mechanisms. QA (300 nM/4 μL in Normal saline) was administered i.c.v. in the hippocampus. QA administration caused depression-like behavior (forced swim test and tail suspension tests), anxiety-like behavior (open field test and elevated plus maze), and elevated anhedonia behavior (sucrose preference test). Furthermore, oxidative–nitrosative stress (increased nitrite content and lipid peroxidation with reduction of GSH), inflammation (increased IL-1β), cholinergic dysfunction, and mitochondrial complex (I, II, and IV) dysfunction were observed in the hippocampus region of QA-treated rats as compared to normal controls. Plumbagin (10 and 20 mg/kg; p.o.) treatment for 21 days significantly ameliorated behavioral and memory deficits in QA-administered rats. Moreover, plumbagin treatment restored the GSH level and reduced the MDA and nitrite level in the hippocampus. Furthermore, QA-induced cholinergic dysfunction and mitochondrial impairment were found to be ameliorated by plumbagin treatment. In conclusion, our results suggested that plumbagin offers a neuroprotective potential that could serve as a promising pharmacological approach to mitigate neurobehavioral changes associated with neurodegeneration.
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Verma H, Verma G, Kumar P. Depression, Anxiety, and Stress During Times of COVID-19: An Analysis of Youngsters Studying in Higher Education in India. THE REVIEW OF SOCIONETWORK STRATEGIES 2021; 15:471-488. [PMID: 35506052 PMCID: PMC8475890 DOI: 10.1007/s12626-021-00089-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/08/2021] [Indexed: 11/28/2022]
Abstract
This study addressed the critical problems of depression, anxiety, and stress, which are prevalent among students pursuing higher education. Specifically, this article aimed to study the level of psychological distress due to the COVID-19 pandemic experienced by young people studying in higher education institutions in India. The study also attempted to identify various coping strategies students adopted to overcome this difficult time. Following a descriptive research design, this study used surveys to collect primary data from 235 students in graduate and undergraduate programs in India. The DASS-21 scale was used to check the levels of depression, anxiety, and stress students experienced. Furthermore, a four-point COPE scale was used to identify coping strategies students adopted. The results showed that students experienced high levels of stress and anxiety during the ongoing COVID-19 pandemic. Although depression levels were not alarming, most students were worried about several aspects of their lives and careers. However, because the data were collected from a relatively small sample, the study is likely not generalisable. Furthermore, most of the data were collected online, which has its limitations. This research likely has significant implications for various stakeholders, such as students, parents, institutions, counsellors, and government and non-government bodies, because it may help them take appropriate actions. These research contributions are original and novel, because the COVID-19 pandemic has posed unprecedented challenges and inspired new solutions to the problems of students and society.
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Affiliation(s)
| | - Garima Verma
- School of Computing, DIT University, Dehradun, India
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Shoib S, Islam SMS, Arafat SY, Hakak SA. Depression and suicidal ideation among the geriatric population of Kashmir, India. Int J Soc Psychiatry 2021; 67:651-655. [PMID: 33100095 DOI: 10.1177/0020764020968592] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Depression is a common disorder that can lead to suicidal behaviours among the geriatric population. AIM We aimed to assess depression, hopelessness, and suicidal ideation among the elderly population of Kashmir. METHODS A community-based cross-sectional study was conducted in three districts of Kashmir between June and August 2019. The sample consisted of 200 persons aged >65 years. Beck's Depression Inventory, Beck's Hopelessness Scale, and the Beck Suicide Ideation scale were used to determine depression, hopelessness, and suicide ideation. Pearson's correlation was performed to assess the relationships between depression, hopelessness, and suicide. RESULTS The prevalence of severe depression with a score of ⩾31 on Beck's Depression Inventory was 56% among the studied population. Most of these elderly were found to have moderate levels of suicidal ideation (62.5%) and hopelessness (61%). Depression had a positive correlation with suicidal ideation (r = 0.35). Hopelessness and suicidal intent had a more significant positive correlation (r = 0.54), as compared to depression and hopelessness (r = 0.43). CONCLUSION More than half of the older persons in Kashmir had depression with superimposed hopelessness which is an important risk factor of suicidal ideation.
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Affiliation(s)
- Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital (JLNMH), Rainawari, Srinagar, Jammu and Kashmir, India
| | | | - Sm Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Dhaka, Bangladesh
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Use of Data to Understand the Social Determinants of Depression in Two Middle-Income Countries: the 3-D Commission. J Urban Health 2021; 98:41-50. [PMID: 34409557 PMCID: PMC8373292 DOI: 10.1007/s11524-021-00559-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2021] [Indexed: 12/11/2022]
Abstract
Depression accounts for a large share of the global disease burden, with an estimated 264 million people globally suffering from depression. Despite being one of the most common kinds of mental health (MH) disorders, much about depression remains unknown. There are limited data about depression, in terms of its occurrence, distribution, and wider social determinants. This work examined the use of novel data sources for assessing the scope and social determinants of depression, with a view to informing the reduction of the global burden of depression.This study focused on new and traditional sources of data on depression and its social determinants in two middle-income countries (LMICs), namely, Brazil and India. We identified data sources using a combination of a targeted PubMed search, Google search, expert consultations, and snowball sampling of the relevant literature published between October 2010 and September 2020. Our search focused on data sources on the following HEALTHY subset of determinants: healthcare (H), education (E), access to healthy choices (A), labor/employment (L), transportation (T), housing (H), and income (Y).Despite the emergence of a variety of data sources, their use in the study of depression and its HEALTHY determinants in India and Brazil are still limited. Survey-based data are still the most widely used source. In instances where new data sources are used, the most commonly used data sources include social media (twitter data in particular), geographic information systems/global positioning systems (GIS/GPS), mobile phone, and satellite imagery. Often, the new data sources are used in conjunction with traditional sources of data. In Brazil, the limited use of new data sources to study depression and its HEALTHY determinants may be linked to (a) the government's outsized role in coordinating healthcare delivery and controlling the data system, thus limiting innovation that may be expected from the private sector; (b) the government routinely collecting data on depression and other MH disorders (and therefore, does not see the need for other data sources); and (c) insufficient prioritization of MH as a whole. In India, the limited use of new data sources to study depression and its HEALTHY determinants could be a function of (a) the lack of appropriate regulation and incentives to encourage data sharing by and within the private sector, (b) absence of purposeful data collection at subnational levels, and (c) inadequate prioritization of MH. There is a continuing gap in the collection and analysis of data on depression, possibly reflecting the limited priority accorded to mental health as a whole. The relatively limited use of data to inform our understanding of the HEALTHY determinants of depression suggests a substantial need for support of independent research using new data sources. Finally, there is a need to revisit the universal health coverage (UHC) frameworks, as these frameworks currently do not include depression and other mental health-related indicators so as to enable tracking of progress (or lack thereof) on such indicators.
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Aggarwal P, Raval VV, Chari U, Raman V, Kadnur Sreenivas K, Krishnamurthy S, Visweswariah AM. Clinicians' Perspectives on Diagnostic Markers for Depression Among Adolescents in India: An Embedded Mixed-Methods Study. Cult Med Psychiatry 2021; 45:163-192. [PMID: 32592142 DOI: 10.1007/s11013-020-09680-8] [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: 10/24/2022]
Abstract
Limited research has investigated whether clinicians around the world find diagnostic criteria for depression that were originally developed in the West are useful with diverse populations. Using an embedded mixed-methods design in India, we examined (a) clinicians' and trainees' (n = 143) ratings of the usefulness of the criteria for Major Depressive Disorder (MDD) outlined in two major diagnostic systems (Diagnostic and Statistical Manual of Mental Disorders-5; DSM-5 and International Classification of Mental and Behavioral Disorders-Tenth Edition; ICD-10), and (b) narrative descriptions of clinical cases of adolescent depression and usefulness of diagnostic and screening instruments in day-to-day practice using semi-structured interviews in a subsample of clinicians (n = 24). Qualitative findings demonstrated that Indian clinicians identified markers of depression that were consistent with the current diagnostic manuals (affective, cognitive, somatic symptoms), and the numeric ratings suggested that clinicians found a majority of DSM-5 and ICD-10 criteria for MDD to be useful. However, Indian clinicians also identified additional markers of adolescent depression (i.e., interpersonal conflicts and issues, impairment in school-related functioning, anger-based symptoms, anxiety-based symptoms, additional somatic complaints not included in DSM-5 or ICD-10), highlighting the need to modify existing diagnostic criteria to be more inclusive. The findings suggest the need for culturally informed diagnostic practices that consider a wide range of clinical presentations of depression among adolescents worldwide.
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Affiliation(s)
- Pankhuri Aggarwal
- Department of Psychology, Miami University, 90 N Patterson Ave, Oxford, OH, 45056, USA.
| | - Vaishali V Raval
- Department of Psychology, Miami University, 90 N Patterson Ave, Oxford, OH, 45056, USA
| | - Uttara Chari
- Department of Psychiatry, St. John's Medical College, Bengaluru, Karnataka, India
| | - Vijaya Raman
- Department of Psychiatry, St. John's Medical College, Bengaluru, Karnataka, India
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De Man J, Absetz P, Sathish T, Desloge A, Haregu T, Oldenburg B, Johnson LCM, Thankappan KR, Williams ED. Are the PHQ-9 and GAD-7 Suitable for Use in India? A Psychometric Analysis. Front Psychol 2021; 12:676398. [PMID: 34054677 PMCID: PMC8155718 DOI: 10.3389/fpsyg.2021.676398] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/16/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Cross-cultural evidence on the factorial structure and invariance of the PHQ-9 and the GAD-7 is lacking for South Asia. Recommendations on the use of unit-weighted scores of these scales (the sum of items' scores) are not well-founded. This study aims to address these contextual and methodological gaps using data from a rural Indian population. METHODS The study surveyed 1,209 participants of the Kerala Diabetes Prevention Program aged 30-60 years (n at risk of diabetes = 1,007 and n with diabetes = 202). 1,007 participants were surveyed over 2 years using the PHQ-9 and the GAD-7. Bifactor-(S - 1) modeling and multigroup confirmatory factor analysis were used. RESULTS Factor analysis supported the existence of a somatic and cognitive/affective subcomponent for both scales, but less explicitly for the GAD-7. Hierarchical omega values were 0.72 for the PHQ-9 and 0.76 for the GAD-7. Both scales showed full scalar invariance and full or partial residual invariance across age, gender, education, status of diabetes and over time. Effect sizes between categories measured by unit-weighted scores versus latent means followed a similar trend but were systematically higher for the latent means. For both disorders, female gender and lower education were associated with higher symptom severity scores, which corresponds with regional and global trends. CONCLUSIONS For both scales, psychometric properties were comparable to studies in western settings. Distinct clinical profiles (somatic-cognitive) were supported for depression, and to a lesser extent for anxiety. Unit-weighted scores of the full scales should be used with caution, while scoring subscales is not recommended. The stability of these scales supports their use and allows for meaningful comparison across tested subgroups. CLINICAL TRIAL REGISTRATION Australia and New Zealand Clinical Trials Registry: ACTRN12611000262909http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=336603&isReview=true.
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Affiliation(s)
- Jeroen De Man
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Pilvikki Absetz
- Collaborative Care Systems Finland, Tampere University, Tampere, Finland
- University of Eastern Finland, Kuopio, Finland
| | | | - Allissa Desloge
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Tilahun Haregu
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Brian Oldenburg
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Leslie C. M. Johnson
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, United States
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Emily D. Williams
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
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14
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Johnson Pradeep R, Ekstrand ML, Selvam S, Heylen E, Mony PK, Srinivasan K. Risk factors for severity of depression in participants with chronic medical conditions in rural primary health care settings in India. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 3. [PMID: 33681860 PMCID: PMC7929528 DOI: 10.1016/j.jadr.2020.100071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Depression and chronic medical disorders are strongly linked. There are limited studies addressing the correlates of the severity of depression in patients with co-morbid disorders in primary care settings. This study aimed to identify the socio-demographic and disease-specific risk factors associated with the severity of depression at baseline among patients participating in a randomized controlled trial (HOPE study). Methods Participants were part of a randomized controlled trial in 49 primary care health centers in rural India. We included adults (≥ 30 years) with at least mild Depression or Anxiety Disorder and at least one Cardiovascular disorder or Type 2 Diabetes mellitus. They were assessed for the severity of depression using the PHQ-9, severity of anxiety, social support, number of co-morbid chronic medical illnesses, anthropometric measurements, HbA1c, and lipid profile. Results Proportionately there were more women in the moderate category of depression than men. Ordinal logistic regression showed co-morbid anxiety and a lower level of education significantly increased the odds of more severe depression, while more social support was significantly negatively associated with depression severity in women. In men, anxiety was positively associated with greater depression severity; while reporting more social support was negatively associated with depression. Limitations This is a cross-sectional study and thus, no causal conclusions are possible. Conclusions Anxiety and poor social support in both genders and lower educational levels in women were associated with increased severity of depression. Early identification of risk factors and appropriate treatment at a primary care setting may help in reducing the morbidity and mortality associated with depression.
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Affiliation(s)
- R Johnson Pradeep
- Department of Psychiatry, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India
| | - Maria L Ekstrand
- Division of Mental Health and Neurosciences, St. John's Research Institute, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India.,Division of Prevention Sciences, University of California, San Francisco, United States
| | - Sumithra Selvam
- Division of Epidemiology & Population Health, St John's Research Institute, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India
| | - Elsa Heylen
- Division of Prevention Sciences, University of California, San Francisco, United States
| | - Prem K Mony
- Division of Epidemiology & Population Health, St John's Research Institute, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India
| | - Krishnamachari Srinivasan
- Department of Psychiatry, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India.,Division of Mental Health and Neurosciences, St. John's Research Institute, St John's Medical College, Sarjapur Road, Bangalore, Karnataka 560034, India
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15
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Bhat BA, Mir RA, Hussain A, Shah IR. Depressive and anxiety symptoms, quality of sleep, and coping during the 2019 coronavirus disease pandemic in general population in Kashmir. MIDDLE EAST CURRENT PSYCHIATRY 2020. [PMCID: PMC7610008 DOI: 10.1186/s43045-020-00069-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
With uncertainty surrounding the 2019 coronavirus disease pandemic, there is no knowledge of the psychological impact of this pandemic on the general public from Kashmir. We aimed to understand the psychological impact in the form of depressive symptoms, anxiety symptoms, quality of sleep, and coping during this pandemic.
Methods
This cross-sectional study was conducted using social networking sites. The questionnaire meant for this study was sent as a link to a respondent. Initial part of questionnaire collected the socio-demographic details of the respondents. Depressive and anxiety symptoms were assessed using Hospital Anxiety and Depression Scale. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the quality of sleep. There was also an open-ended question to look for coping skills used.
Results
The majority of our respondents were below 45 years (around 95%) with 54.9% from 18 to 30 years age group. 72.3% were males and 27.7% were females. 58.7% were from rural background. 55.7% were employed, and 32.2% were students. In our respondents, 55% had anxiety symptoms, 55% had depressive symptoms, around 53% had poor quality of sleep, and around 30% of used maladaptive coping skills. Significant depressive symptoms were there in the younger age group, 18–30 years (p = 0.03). Significant depressive symptoms and anxiety symptoms were present in females (p = 0.01 and 0.006, respectively). In urban population, significant anxiety symptoms (p = 0.03) were present. The mean score for anxiety symptoms and depressive symptoms was 8.05 ± 4.53 and 8.07 ± 4.56, respectively. Mean global PSQI score was 6.90 ± 3.82 and was positively correlated with score on depressive symptom scale (p = 0.001) as well as score on anxiety symptom scale (p = 0.001).
Conclusion
Younger people, females, those living in urban conditions, and those using maladaptive coping skills are likely to have anxiety symptoms and depressive symptoms as well as poor quality of sleep.
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16
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Bayes-Marin I, Sanchez-Niubo A, Egea-Cortés L, Nguyen H, Prina M, Fernández D, Haro JM, Olaya B. Multimorbidity patterns in low-middle and high income regions: a multiregion latent class analysis using ATHLOS harmonised cohorts. BMJ Open 2020; 10:e034441. [PMID: 32690500 PMCID: PMC7371222 DOI: 10.1136/bmjopen-2019-034441] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 05/17/2020] [Accepted: 05/27/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Our aim was to determine clusters of non-communicable diseases (NCDs) in a very large, population-based sample of middle-aged and older adults from low- and middle-income (LMICs) and high-income (HICs) regions. Additionally, we explored the associations with several covariates. DESIGN The total sample was 72 140 people aged 50+ years from three population-based studies (English Longitudinal Study of Ageing, Survey of Health, Ageing and Retirement in Europe Study and Study on Global Ageing and Adult Health) included in the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project and representing eight regions with LMICs and HICs. Variables were previously harmonised using an ex-post strategy. Eight NCDs were used in latent class analysis. Multinomial models were made to calculate associations with covariates. All the analyses were stratified by age (50-64 and 65+ years old). RESULTS Three clusters were identified: 'cardio-metabolic' (8.93% in participants aged 50-64 years and 27.22% in those aged 65+ years), 'respiratory-mental-articular' (3.91% and 5.27%) and 'healthy' (87.16% and 67.51%). In the younger group, Russia presented the highest prevalence of the 'cardio-metabolic' group (18.8%) and England the 'respiratory-mental-articular' (5.1%). In the older group, Russia had the highest proportion of both classes (48.3% and 9%). Both the younger and older African participants presented the highest proportion of the 'healthy' class. Older age, being woman, widowed and with low levels of education and income were related to an increased risk of multimorbidity. Physical activity was a protective factor in both age groups and smoking a risk factor for the 'respiratory-mental-articular'. CONCLUSION Multimorbidity is common worldwide, especially in HICs and Russia. Health policies in each country addressing coordination and support are needed to face the complexity of a pattern of growing multimorbidity.
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Affiliation(s)
- Ivet Bayes-Marin
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Albert Sanchez-Niubo
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Laia Egea-Cortés
- Center of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Hai Nguyen
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Matthew Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Daniel Fernández
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Serra Húnter fellow. Department of Statistics and Operations Research, Polytechnic University of Catalonia, Barcelona, Spain
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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17
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Mohan G, Kandaswamy DK, Chikkaharohalli Ramakrishna MK. Identification of nonclinical interventions for spontaneous recovery of depression using mathematical modeling. Brain Behav 2020; 10:e01550. [PMID: 32026616 PMCID: PMC7066340 DOI: 10.1002/brb3.1550] [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] [Received: 04/12/2019] [Accepted: 01/04/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In order to make a risk or vulnerability assessment of major depressive disorder (MDD) in adolescents and suggest nonclinical interventions for spontaneous recovery for low-vulnerable adolescents a novel network mathematical model has been proposed. METHODS In the existing network theory, the theoretical model consists of a symptom network surrounded by the triggering factors as external field which are the cause for adolescents being diagnosed with MDD. But in our network model, the triggering external field is replaced by nonclinical interventions, easily implementable in schools and colleges with teachers as facilitators. RESULTS The four variables of subjective well-being (SWB), emotional quotient-Attention (EQ-A), emotional quotient-Clarity (EQ-C) and emotional quotient-Reparation (EQ-R) were the symptoms considered for stratification of the vulnerability. The mathematical model was created using the four symptoms and the four nonclinical interventions of technology use, physical exercise, peer pressure positive and peer pressure negative, and their inter-relationship. CONCLUSION A balance of tech use and physical exercise and of the peer pressure help maintain the adolescents in the low-vulnerability group in our study with 227 adolescents in Bangalore. Furthermore, we predict that positive peer pressure and physical exercise could increase the EQ thus suggesting a preventive model for the onset of major depressive disorder (MDD).
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Affiliation(s)
- Gayathree Mohan
- Department of Physics, MVJ Engineering College, Bangalore, India
| | - Dinesh Kumar Kandaswamy
- Department of Epidemiology and Public Health, Central University of Tamilnadu, Thiruvarur, India.,School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
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18
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Maulik PK, Devarapalli S, Kallakuri S, Bhattacharya A, Peiris D, Patel A. The Systematic Medical Appraisal Referral and Treatment Mental Health Project: Quasi-Experimental Study to Evaluate a Technology-Enabled Mental Health Services Delivery Model Implemented in Rural India. J Med Internet Res 2020; 22:e15553. [PMID: 32130125 PMCID: PMC7068463 DOI: 10.2196/15553] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/28/2019] [Accepted: 12/16/2019] [Indexed: 12/25/2022] Open
Abstract
Background Although around 10% of Indians experience depression, anxiety, or alcohol use disorders, very few receive adequate mental health care, especially in rural communities. Stigma and limited availability of mental health services contribute to this treatment gap. The Systematic Medical Appraisal Referral and Treatment Mental Health project aimed to address this gap. Objective This study aimed to evaluate the effectiveness of an intervention in increasing the use of mental health services and reducing depression and anxiety scores among individuals at high risk of common mental disorders. Methods A before-after study was conducted from 2014 to 2019 in 12 villages in Andhra Pradesh, India. The intervention comprised a community antistigma campaign, with the training of lay village health workers and primary care doctors to identify and manage individuals with stress, depression, and suicide risk using an electronic clinical decision support system. Results In total, 900 of 22,046 (4.08%) adults screened by health workers had increased stress, depression, or suicide risk and were referred to a primary care doctor. At follow-up, 731 out of 900 (81.2%) reported visiting the doctor for their mental health symptoms, compared with 3.3% (30/900) at baseline (odds ratio 133.3, 95% CI 89.0 to 199.7; P<.001). Mean depression and anxiety scores were significantly lower postintervention compared with baseline from 13.4 to 3.1 (P<.001) and from 12.9 to 1.9 (P<.001), respectively. Conclusions The intervention was associated with a marked increase in service uptake and clinically important reductions in depression and anxiety symptom scores. This will be further evaluated in a large-scale cluster randomized controlled trial.
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Affiliation(s)
- Pallab K Maulik
- George Insitute for Global Health, New Delhi, India.,University of New South Wales, Sydney, Australia.,George Institute for Global Health, University of Oxford, Oxford, United Kingdom
| | | | | | | | - David Peiris
- University of New South Wales, Sydney, Australia.,George Institute for Global Health, Sydney, Australia
| | - Anushka Patel
- University of New South Wales, Sydney, Australia.,George Institute for Global Health, Sydney, Australia
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19
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Goel AD, Akarte SV, Agrawal SP, Yadav V. Longitudinal assessment of depression, stress, and burnout in medical students. J Neurosci Rural Pract 2019; 7:493-498. [PMID: 27695226 PMCID: PMC5006458 DOI: 10.4103/0976-3147.188625] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Medical students can and do suffer from mental disorders is a concept yet to get wide acceptance. There are few studies comprehensively evaluating depression, stress, and burnout in medical students, especially in a longitudinal way in India. The current study aims to assess the impact of medical education on the development of psychological morbidities and the role of personality. Materials and Methods: First-year medical students of a leading medical college of India were enrolled on admission and given anonymized, validated, self-administered questionnaires assessing depression, stress, burnout, and personality. This was repeated at the end of 1st year. Data were analyzed independently as questionnaires were anonymized. Results: We found that 1st year of medical college showed a significantly increasing depression (P < 0.01) and stress (P < 0.01). Overall burnout did not increase significantly. However, only disengagement dimension of burnout increased significantly. Personalities with weak capacity to adjust had a significant positive correlation with depression (r = 0.277, P < 0.001) and stress scores (r = 0.210, P = 0.008). However, burnout did not correlate with any of the personality dimensions. Conclusion: Right from the 1st year of medical education students perceive high-stress levels and have a high risk of depression. Burnout starts to creep in at least in the form of disengagement. This study provides a sound groundwork for planning interventions to reduce student's mental morbidity and avoid burnout.
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Affiliation(s)
- Akhil D Goel
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sulbha V Akarte
- Department of Community Medicine, Grant Medical College, Mumbai, Maharashtra, India
| | - Sumita P Agrawal
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Vikas Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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20
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Firoozabadi A, Golshani S, Razeghian L, Rahimi S, Sepehry AA, Farnia V, Tatari F, Hookari S, Alikhani M. Dissociative Experiences In Iranian Depressed Patients. J Trauma Dissociation 2019; 20:445-456. [PMID: 30945624 DOI: 10.1080/15299732.2019.1597804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In the present study, 229 major depressive disorder (MDD) patients (57.6% female; 42.4% male) were selected by convenience sampling and examined for rate of dissociative experiences. Research tools were Dissociative Experiences Scale (DES) and demographic questionnaire. Group difference examinations were performed for gender, settlement region (place of residence), and chief complaints using standard t-test, analysis of variance, and Chi-square tests as appropriate. Ordinal regression was implemented for model building. The average age of the sample was 36.78 ± 10.73. Of which, 150 (65.5%) lived in the urban and 79 (34.5%) in the rural areas. The chief complaint of the 146 patients (63.8%) was psychiatric symptoms specific to MDD, and the remaining 83 patients (36.2%) had physical symptoms. The average DES score was 10.59 ± 13.59; and a significant mean DES score differences (P < 0.01) between patients' referred to physician for physical versus psychological complaints (physical: 23.61 ± 14.39; psychological: 3.19 ± 4.5) and geographic settlements (rural: 19.58 ± 15.13; urban: 5.86 ± 9.86) were observed. This study highlights the presence of subtype within MDD patients with significant dissociative tendencies. Given the relationship between trauma history and dissociation, this subgroup could be considered as probable cases with childhood history of abuse, lending to use dissociation as a defense mechanism. Given the evidence for promising results of trauma-focused psychotherapy in treating such patients, paying proper attention to childhood history of depression especially with somatization may minimize pain and suffering of these individuals overtime.
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Affiliation(s)
- Ali Firoozabadi
- a Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Hafez Hospital , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Senobar Golshani
- b Substance abuse prevention research center , Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Lila Razeghian
- c Department of Psychiatry , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Somayeh Rahimi
- c Department of Psychiatry , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Amir Ali Sepehry
- d Faculty of Medicine, Division of Neurology , UBC , Vancouver , Canada
| | - Vahid Farnia
- b Substance abuse prevention research center , Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Faezeh Tatari
- b Substance abuse prevention research center , Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Sara Hookari
- b Substance abuse prevention research center , Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Mostafa Alikhani
- b Substance abuse prevention research center , Kermanshah University of Medical Sciences , Kermanshah , Iran
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21
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Majumdar A, Ramya S, Ramakrishnan J. Depression, anxiety, and bodily pain independently predict poor sleep quality among adult women attending a primary health center of Puducherry, India. J Family Med Prim Care 2019; 8:1182-1188. [PMID: 31041271 PMCID: PMC6482758 DOI: 10.4103/jfmpc.jfmpc_118_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: Sleep disorders and mental health problems are common diagnoses in primary care settings. The objective of this study was to estimate the magnitude of poor sleep, depression, and anxiety through opportunistic screening and to find out the independent predictors of poor sleep quality among female participants. Materials and Methods: A hospital-based study was conducted in the outpatient department (OPD) of an urban primary health center of Puducherry. Patients and accompanying healthy attendants ≥ 18 years of age who visited the OPD for any reason were included. Those with serious acute illness, previously diagnosed mental illness, pregnant women, and women in postpartum period (upto 6 weeks) were excluded. Systematic random sampling was used to select the participants. A semi-structured questionnaire was used to collect sociodemographic and clinical details along with the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale. Height and weight were also measured. Results: A total of 301 participants were recruited. Mean age of the participants was 49.4 (standard deviation 15.2) years. Magnitude of poor sleep (PSQI score > 5), abnormal anxiety, and abnormal depression were 118 (39.2%), 60 (19.9%), and 28 (9.3%) respectively. Multivariate logistic regression analysis showed that history of pain [odds ratio (OR) 3.2 (1.6–6.5), P = 0.001], abnormal anxiety [OR 2.5 (1.2–5.6), P = 0.021], and abnormal depression [OR 4.3 (1.4–13.2), P = 0.01] independently predicted poor sleep quality among females. Conclusion: OPD-based opportunistic screening for sleep and mental health problems should be routinely conducted by primary care and family physicians.
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Affiliation(s)
- Anindo Majumdar
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - S Ramya
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Jayalakshmy Ramakrishnan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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22
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Mohammadi MR, Alavi SS, Ahmadi N, Khaleghi A, Kamali K, Ahmadi A, Hooshyari Z, Mohamadian F, Jaberghaderi N, Nazaribadie M, Sajedi Z, Farshidfar Z, Kaviani N, Davasazirani R, Shahbakhsh AJ, Rad MR, Shahbazi K, Khodaverdloo RR, Tehrani LN, Nasiri M, Naderi F, Kiani A, Chegeni M, Hashemi Nasab SM, Ghaneian M, Parsamehr H, Nilforoushan N, Amiri S, Fooladi MF, Mohammadzadeh S, Ahmadipour A, Sarraf N, Hojjat SK, Nadermohammadi M, Mostafavi SA, Zarafshan H, Salmanian M, Shakiba A, Ashoori S. The prevalence, comorbidity and socio-demographic factors of depressive disorder among Iranian children and adolescents: To identify the main predictors of depression. J Affect Disord 2019; 247:1-10. [PMID: 30640024 DOI: 10.1016/j.jad.2019.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 12/23/2018] [Accepted: 01/04/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Depressive disorders are a major public health problem in developed and developing countries. Recently, several risk factors have been described for depressive disorders in children and adolescents. The aim of the present study was to identify the main risk factors that can affect the incidence of depression in Iranian children and adolescents. METHODS A total of 30,546 children and adolescents (between 6 and 18 years of age) participated in a cross-sectional study to identify the predictors of depressive disorders. Depressive disorders were assessed using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL). In addition, a demographic characteristics questionnaire was completed by parents of the participants. The data was analyzed using the SPSS22 software via performing the descriptive analysis and the multiple logistic regression analysis methods. P-values less than 0.05 were considered statistically significant. RESULTS Results showed that a higher age (15-18), being female, and the father's unemployment were associated with an increased odds ratio for depressive disorders. The age of 10-14 (OR = 2.1; 95% CI, 1.57-2.81), the age of 15-18 (OR = 4.44; 95% CI, 3.38-5.83), female gender (OR = 1.44; 95% CI, 1.2-1.73) and the father's unemployment (OR = 1.59; 95% CI, 1.01-2.5) were significant positive predictors, whereas, the mother's job (as a housewife) (OR = 0.66; 95% CI, 0.45-0.96) and a history of psychiatric hospitalization of the father and mother (OR = 0.34; 95% CI, 0.15-0.78 and OR = 0.34; 95% CI, 0.14-0.84) were negative predictors for depressive symptoms. CONCLUSION Depressive symptoms are common in children and adolescents and are correlated with age and gender. The assessment of the prevalence of psychiatric disorders, especially the depressive disorders and their comorbidities, may help to prevent mood disorders in children and adolescents.
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Affiliation(s)
- Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Seyyed Salman Alavi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nastran Ahmadi
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Ali Khaleghi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Koorosh Kamali
- Department of Public Health, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Ameneh Ahmadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zahra Hooshyari
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fathola Mohamadian
- Department of Psychology, Psychosocial Injuries Research Center, Ilam University of Medical Science, Ilam, Iran.
| | - Nasrin Jaberghaderi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Marzieh Nazaribadie
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Zahra Sajedi
- Faculty of Psychology and Educational Sciences, University of Semnan, Semnan, Iran.
| | | | - Nahid Kaviani
- Health Deputy, Kerman University of Medical Sciences, Kerman, Iran.
| | - Reza Davasazirani
- Community Mental Health and Addiction Health Department of Khuzestan Province, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | | | | | | | | | | | | | - Fatemeh Naderi
- Hormozgan University of Medical Sciences, Hormozgan, Iran.
| | - Arezou Kiani
- Urmia University of Medical Sciences, Urmia, Iran.
| | | | | | - Mahnaz Ghaneian
- Department of Psychology, Islamic Azad University, Najafabad Branch, Najafabad, Iran.
| | - Hosein Parsamehr
- Lorestan University of Medical Sciences, Imam Reza Psychiatric Hospital, Khorramabad, Iran.
| | | | - Shahrokh Amiri
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahbod Fadaei Fooladi
- Department of Psychology and Educational Sciences, Allameh Tabatabai University, Tehran, Iran.
| | - Soleiman Mohammadzadeh
- Department of Psychiatry, Neuroscience Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Ahmad Ahmadipour
- Department of Psychiatry, Booshehr University of Medical Sciences, Khalij-E Fars Hospital. Booshehr, Iran.
| | - Nasrin Sarraf
- Department of Child and Adolescents Psychiatry, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Seyed Kaveh Hojjat
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran.
| | | | - Seyed-Ali Mostafavi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hadi Zarafshan
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Maryam Salmanian
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Alia Shakiba
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Simin Ashoori
- Mashhad University of Medical Sciences, Mashhad, Iran.
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Ogbo FA, Mathsyaraja S, Koti RK, Perz J, Page A. The burden of depressive disorders in South Asia, 1990-2016: findings from the global burden of disease study. BMC Psychiatry 2018; 18:333. [PMID: 30326863 PMCID: PMC6192293 DOI: 10.1186/s12888-018-1918-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 10/02/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Globally, depressive disorders are one of the most common forms of mental illness. Using data from the most recent Global Burden of Disease, Injury, and Risk Factor Study 2016 (GBD 2016), we aimed to describe the burden of disease attributable to depressive disorders in terms of prevalence and disability-adjusted life years (DALYs) in South Asia countries (namely India, Pakistan, Bangladesh, Nepal and Bhutan). METHODS GBD 2016 used epidemiological data on depressive disorders (major depression and dysthymia) from South Asia and a Bayesian meta-regression tool (DisMod-MR 2.1) to model prevalence and DALYs of depressive disorders by age, sex, country and year. DALYs were calculated from the years lived with disability (YLDs), derived from the prevalence of depressive disorders and disability weights, obtained from a community and internet-based surveys. The analyses adjusted for comorbidity, data sources and multiple modelling, and estimates were presented with 95% uncertainty intervals (UI). RESULTS In 2016, the age-standardised prevalence of depressive disorders in South Asia was 3.9% (95% UI: 3.6-4.2%), 4.4% (95% UI: 4.4-4.8%) in Bangladesh, 3.9% (95% UI: 3.6-4.2%) in India, 3.0% (95% UI: 2.8-3.3%) in Pakistan, 4.0% (95% UI: 3.7-4.3%) in Nepal and 3.7% (95% UI: 3.4-4.1%) in Bhutan. In South Asia, depressive disorders accounted for 9.8 million DALYs (95% UI: 6.8-13.2 million) or 577.8 (95% UI: 399.9-778.9) per 100,000 population in 2016. Of these, major depressive disorders (MDD) accounted for 7.8 million DALYs (95% UI: 5.3-10.5 million). India generated the largest numbers of DALYs due to depressive disorders and MDD, followed by Bangladesh and Pakistan. DALYs due to depressive disorders were highest in females and older adults (75-79 years) across all countries. CONCLUSION Our findings show the substantial public health burden of depressive disorders in South Asian populations and healthcare systems. Given the scale of depressive disorders, improvement in overall population health is possible if South Asian countries prioritise the prevention and treatment of depressive disorders.
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Affiliation(s)
- Felix Akpojene Ogbo
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Sruthi Mathsyaraja
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Rajeendra Kashyap Koti
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Janette Perz
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Andrew Page
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2571 Australia
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Kurhe Y, Mahesh R. Ondansetron ameliorates depression associated with obesity in high-fat diet fed experimental mice: An investigation-based on the behavioral, biochemical, and molecular approach. Indian J Pharmacol 2018; 49:290-296. [PMID: 29326489 PMCID: PMC5754936 DOI: 10.4103/ijp.ijp_805_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION: Obesity is an important risk factor for depression as more than half of the obese population is susceptible for depression at double rate. Our earlier studies reported the antidepressant potential of 5-HT3 receptor antagonist, ondansetron (OND) in depression associated obesity using behavioral tasks. The present research work is aimed to evaluate the effect of OND on depression associated with obesity with special emphasis on biochemical and molecular mechanisms such as hippocampal brain-derived neurotrophic factor (BDNF), cyclic adenosine monophosphate (cAMP), 5-hydroxytryptamine (5-HT), hippocampal histological examination and immunohistochemical expression of p53 proteins. MATERIALS AND METHODS: Mice were fed with high-fat diet (HFD) for 14 weeks, followed by treatment schedule for 28 days with vehicle/OND (0.5 and 1 mg/kg, p.o.)/reference antidepressant escitalopram (10 mg/kg, p.o.). Subsequently, animals were screened in the behavioral tests of depression such as forced swim test (FST) and sucrose preference test (SPT), biochemical estimations including hippocampal cAMP, BDNF and 5-HT, and molecular assays mainly histology and p53 expression of dentate gyrus (DG). RESULTS: HFD-fed mice showed increased immobility time in FST, reduced sucrose consumption in SPT, decreased level of signal transduction factor cAMP, neuronal growth factor BDNF and neurotransmitter 5-HT in the hippocampus, and raised and p53 expression neuronal damage in the DG region of mice fed with HFD in comparison to the mice fed with normal pellet diet. Chronic treatment with OND (0.5 and 1 mg/kg, p.o.) significantly inhibited the behavioral, biochemical and molecular modifications in HFD-fed mice. CONCLUSION: In the preliminary study, OND attenuated depression associated with obesity in mice fed with HFD using various assays procedures, at least in part by the modulation of serotonergic transmission.
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Affiliation(s)
- Yeshwant Kurhe
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani, Rajasthan, India
| | - Radhakrishnan Mahesh
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani, Rajasthan, India
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Konda PR, Sharma PK, Gandhi AR, Ganguly E. Geriatric Depression and its Correlates among South Indian Urbans. ACTA ACUST UNITED AC 2018; 7. [PMID: 31406629 PMCID: PMC6690607 DOI: 10.4172/2167-1044.1000314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: Geriatric depression is a growing global problem, expected to be the leading cause of mortality in the next decade. We attempted to explore the previously unidentified burden of depression and its correlates amongst South Indian elderly residing in an urban area. Methods: A cross sectional study including 100 community dwelling urban elders aged 60 years and older was conducted. A predesigned questionnaire was used to collect data on sociodemographic variables, chronic health conditions, changes in vision and cognition, addictions, and medication usage. Depression was assessed using Geriatric Depression Scale. Other measurements included anthropometry and blood pressure. Logistic regression was done to identify the independently associated correlates of depression. Results: The prevalence of geriatric depression was 23%. 15.4% men and 31.2% women had depression. On logistic regression, the independent correlates of depression were living single (OR:4.26; 95% CI:1.06–17.09), poor self-rated health (OR:12.09; 95% CI:1.41–103.14), bedridden (OR:5.29; 95% CI:1.21–23.04) and osteoarthritis (OR: 4.91; 95% CI:1.39–17.28). Conclusion: The burden of depression in our urban geriatric population was moderate. Several correlates were positively associated. While addressing geriatric morbidity, screening for elderly depression, as well as exploration and management of related factors would be of significance.
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Affiliation(s)
| | - Pawan Kumar Sharma
- Department of Epidemiology, University of Pittsburgh, Fogarty International NIH, USA and Share India.,Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
| | - Atul R Gandhi
- Consultant Statistician & Chief Manager, Monitoring and Evaluation Unit, EdelGive Foundation, Edelweiss House, Mumbai, India
| | - Enakshi Ganguly
- Department of Epidemiology, University of Pittsburgh, Fogarty International NIH, USA and Share India.,Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
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Kallakuri S, Devarapalli S, Tripathi AP, Patel A, Maulik PK. Common mental disorders and risk factors in rural India: baseline data from the SMART mental health project. BJPsych Open 2018; 4:192-198. [PMID: 29988932 PMCID: PMC6034434 DOI: 10.1192/bjo.2018.28] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/05/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND About 10% Indians suffer from stress, depression or substance use disorders. Few receive care for these problems, especially in rural areas. AIMS As part of a broader initiative to deliver technology-enabled mental health services for rural communities (adults ≥18 years), information was collected about the prevalence of depression, anxiety and suicide risk. METHOD The study was conducted in 12 villages in the West Godavari district of Andhra Pradesh. Depression and anxiety were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, respectively. Additionally, data were collected about sociodemographic factors and stressful events, among others. RESULTS Anxiety, depression and suicidal ideation affected 10.8, 14.4 and 3.5% of participants, respectively (N = 22 377). These were more common among women, and among those who were aged 30-59 years, uneducated, or divorced/ separated/ widowed. Stress due to financial loss was significant. CONCLUSIONS The study identified a significant number of people at risk of depression, anxiety and suicide, and needing care. DECLARATION OF INTEREST None.
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Affiliation(s)
- Sudha Kallakuri
- Research Assistant, George Institute for Global Health, New Delhi, India
| | | | | | - Anushka Patel
- Chief Scientist, George Institute for Global Health, Sydney, Australia and Professor of Medicine, University of New South Wales, Sydney, Australia
| | - Pallab K Maulik
- Deputy Director and Head of Research, George Institute for Global Health, New Delhi, India, and Associate Professor, Faculty of Medicine, University of New South Wales, Sydney, Australia and Senior Research Associate, George Institute for Global Health, University of Oxford, Oxford, UK
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Chan BT, Pradeep A, Mayer KH, Kumarasamy N. Attitudes of Indian HIV Clinicians Toward Depression in People Living with HIV. Ann Glob Health 2018; 82:792-797. [PMID: 28283131 DOI: 10.1016/j.aogh.2016.04.672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Depression is highly prevalent in people living with HIV (PLHIV) and is associated with increased morbidity and mortality. In India, where access to mental health specialists is limited, little is known about the attitude of HIV clinicians toward depression in PLHIV. METHODS We administered a questionnaire to HIV clinicians attending the 2015 Chennai Antiretroviral Therapy Symposium that assessed respondents' level of agreement with 29 statements regarding the etiology, importance, and management of depression and whether they felt capable and willing to manage depression in PLHIV. RESULTS The 69 respondents were from 9 Indian states. Most respondents agreed that depression in PLHIV is a serious problem (91%) and is associated with poorer HIV-related outcomes (62%-81%). Although most respondents (76%) reported feeling comfortable discussing mental health problems with PLHIV, almost half (48%) admitted that lack of knowledge and training about mental health issues hindered the diagnosis and treatment of depression in PLHIV. With few exceptions, there were no significant differences in responses by gender, urban/rural practice location, or government versus private practice. CONCLUSIONS Indian HIV clinicians believe that depression in PLHIV is important and are willing to manage depression in the HIV primary care setting. These findings suggest that HIV clinicians require further training to deliver evidence-based interventions to treat PLHIV with depression.
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Affiliation(s)
- Brian T Chan
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
| | - Amrose Pradeep
- Y.R. Gaitonde Centre for AIDS Research and Education, Chennai, India
| | - Kenneth H Mayer
- Harvard Medical School, Boston, MA; Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA; Fenway Health, Boston, MA
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Wilkerson JM, Di Paola A, Rawat S, Patankar P, Rosser BRS, Ekstrand ML. Substance Use, Mental Health, HIV Testing, and Sexual Risk Behavior Among Men Who Have Sex With Men in the State of Maharashtra, India. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2018; 30:96-107. [PMID: 29688773 PMCID: PMC6214349 DOI: 10.1521/aeap.2018.30.2.96] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Among 433 men who have sex with men in Maharashtra, India who completed an online survey, 23% reported hazardous drinking, 12% illicit substance, and 9% polysubstance use. The overall prevalence of depression and intimate partner violence (IPV) were 58% and 56%, respectively. Participants engaging in hazardous drinking had more sexual partners and were less likely to be married to women. Participants reporting illicit substance use or polysubstance use were more likely to have been out, had more sexual partners, or experienced IPV. Those reporting illicit substance use were more likely to engage in condomless anal sex. Based on our findings, we suggest that public health interventions integrate HIV, substance use, and mental health services.
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Affiliation(s)
- J Michael Wilkerson
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas
| | - Angela Di Paola
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas
| | | | | | - B R Simon Rosser
- University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Maria L Ekstrand
- University of California San Francisco Center for AIDS Prevention Studies, San Francisco, California
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Maulik PK, Kallakuri S, Devarapalli S, Vadlamani VK, Jha V, Patel A. Increasing use of mental health services in remote areas using mobile technology: a pre-post evaluation of the SMART Mental Health project in rural India. J Glob Health 2018; 7:010408. [PMID: 28400954 PMCID: PMC5370210 DOI: 10.7189/jogh.07.010408] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background About 25% of the Indian population experience common mental disorders (CMD) but only 15–25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile–technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence–based mental health care for stress, depression, and suicidal risk in 30 remote villages in the state of Andhra Pradesh, India. Methods The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health project between May 2014 and April 2016 trained lay village health workers (Accredited Social Health Activists – ASHAs) and primary care doctors to screen, diagnose and manage individuals with common mental disorders using an electronic decision support system. An anti–stigma campaign using multi–media approaches was conducted across the villages at the outset of the project. A pre–post evaluation using mixed methods assessed the change in mental health service utilization by screen positive individuals. This paper reports on the quantitative aspects of that evaluation. Results Training was imparted to 21 ASHAs and 2 primary care doctors. 5007 of 5167 eligible individuals were screened, and 238 were identified as being positive for common mental disorders and referred to the primary care doctors for further management. Out of them, 2 (0.8%) had previously utilized mental health services. During the intervention period, 30 (12.6%) visited the primary care doctor for further diagnosis and treatment, as advised. There was a significant reduction in the depression and anxiety scores between start and end of the intervention among those who had screened positive at the beginning. Stigma and mental health awareness in the broader community improved during the project. Conclusions The intervention led to individuals being screened for common mental disorders by village health workers and increase in mental health service use by those referred to the primary care doctor. The model was deemed feasible and acceptable. The effectiveness of the intervention needs to be demonstrated using more robust randomized controlled trials, while addressing the issues identified that will facilitate scale up.
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Affiliation(s)
- Pallab K Maulik
- The George Institute for Global Health, New Delhi, India; The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
| | | | | | | | - Vivekanand Jha
- The George Institute for Global Health, New Delhi, India; The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
| | - Anushka Patel
- The George Institute for Global Health, University of Sydney, Sydney, Australia
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Millard C, Kadam AB, Mahajan R, Pollock AM, Brhlikova P. Availability of brands of six essential medicines in 124 pharmacies in Maharashtra. J Glob Health 2018; 8:010402. [PMID: 29423188 PMCID: PMC5782832 DOI: 10.7189/jogh.08.010402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this study is to assess the availability and rational use of six essential medicines in private retail outlets in Maharashtra state. The study focuses on the range of brands for each medicine, and the availability of these brands in the pharmacies. The medicines were chosen because they are included in the World Health Organization's (WHO) essential medicines list (EML), the Indian national and Maharashtra state medicines list, and are all included in existing Indian public health initiatives and national disease control programmes. Methods Data was gathered on the availability of the medicines and the range and frequency of brands in 124 private retail pharmacies between January and May 2012. As there is currently no centralised database in India of available pharmaceutical brands, we collected data on the range of products of the 6 essential medicines available in the Indian market by consulting three open access Indian pharmaceutical databases, CIMS India, Medindia, and Medguide, and the commercial database, Pharmatrac; we compared this data with the results of the survey. The six essential medicines used in this study are: artemisinin (malaria), lamivudine (HIV/AIDS), rifampicin (tuberculosis control), oxytocin (reproductive health), fluoxetine (mental health) and metformin (diabetes). Results The study found that for each of the selected medicines there were multiple approved products listed in Indian databases, 2186 in total. The Pharmatrac database lists only 1359 brands of the selected medicines; 978 (72%) of these had zero sales in 2011-2012. Our survey found very low availability of the brands: 17% Pharmatrac marketed brands (163/978) and 12% of all Pharmatrac brands (163/1359) were available. Metformin was the only medicine with high availability in the study pharmacies at 91%, Rifampacin was the second highest at 64.5%; the other four medicines were available in less than half the pharmacies. A small number of brands were dominating the market. Conclusion the survey shows that market competition has generated a large number of brands of the six study medicines but this has not translated into sufficient availability of these medicines in the study pharmacies. The data calls for a review of available brands, taking into consideration levels of sale and grounds for approval, and the setting up of a centralised database of registered pharmaceutical products.
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Affiliation(s)
- Colin Millard
- Institute of Health and Society, Newcastle University, Newcastle, United Kingdom
| | - Abhay B Kadam
- Lakshya, Society for Public Health Education and Research, and Foundation for Research in Community Health, Mumbai, India
| | | | - Allyson M Pollock
- Institute of Health and Society, Newcastle University, Newcastle, United Kingdom
| | - Petra Brhlikova
- Institute of Health and Society, Newcastle University, Newcastle, United Kingdom
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Mary Kapanee AR, Meena KS, Nattala P, Manjunatha N, Sudhir PM. Perceptions of Accredited Social Health Activists on Depression: A Qualitative Study from Karnataka, India. Indian J Psychol Med 2018; 40:11-16. [PMID: 29403123 PMCID: PMC5795672 DOI: 10.4103/ijpsym.ijpsym_114_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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 Depression is a significant public health concern in India, associated with a large treatment gap. Assessing perceptions of Accredited Social Health Activists (ASHAs) on depression can be invaluable as they are selected to work at the interface between their own communities and the health-care delivery system. AIMS AND OBJECTIVES This study aimed at utilizing a qualitative approach to examine the ASHAs' understanding of depression, their mental health-care practices specific to depression, and their capacity-building needs with regard to identification and helping persons with depression. SUBJECTS AND METHODS A cross-sectional qualitative study using two focus group discussions was conducted. The sample comprised 14 ASHAs in the age range of 25-45 years from Bengaluru urban district. The data were analyzed manually by the method of directed content analysis. RESULTS The ASHAs were found to have inadequate knowledge of the signs and symptoms of depression, its biopsychosocial nature, and its impact on functioning. Causation of depression was narrated in terms of psychosocial stressors. The majority expressed the need for primarily psychosocial interventions for depression. All participants reported their motivation to obtain training in identifying persons with depression and providing simple psychosocial intervention for them. CONCLUSION This study indicates that ASHAs have poor knowledge of depression, which could be leading to its low recognition and treatment in the communities they work in. They are therefore likely to benefit from capacity building on depression which includes familiar nomenclature, biopsychosocial elucidation of the illness, life-span approach, understanding of its impact on various domains of functioning, and the treatments available.
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Affiliation(s)
- Aruna Rose Mary Kapanee
- Department of Clinical Psychology, M. V. Govindaswamy Center, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - K S Meena
- Department of Mental Health Education, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Prasanthi Nattala
- Department of Nursing, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Paulomi M Sudhir
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Desai ND, Chavda P, Shah SH, Shah N, Shah SN, Sharma E. A novel approach to suicide prevention - Educating when it matters. Ind Psychiatry J 2018; 27:115-123. [PMID: 30416302 PMCID: PMC6198601 DOI: 10.4103/ipj.ipj_10_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Looking at the burden of suicide, there is a dire need for medical schools to incorporate suicide prevention training. Effective communication helps in early detection and management of suicidal behavior. Medical students can act as a GATEKEEPER if they receive adequate training. METHODOLOGY This was an educational intervention study done at tertiary care teaching hospital to assess the knowledge and attitude of medical students toward depression and suicide and to impart and assess communication skills for suicide prevention in one of the four batches of students in 4th semester. Pretest was conducted to assess knowledge and attitude toward depression and suicide, followed by training using interactive lectures, demonstration of interview, and hands-on training with patients and role-plays. The posttest and objective structured clinical examination (OSCE) were administered for skill assessment. Feedback was taken regarding this intervention. RESULTS The mean marks of the pre- and post-test were 8.96 (8.3-9.6) and 14.58 (13.8-15.3), respectively, out of 25. The difference was statistically significant (t = 13.24, P ≤ 0.0001) which suggests improvement in knowledge. We found mixed responses in attitude statements showing limited change. Mean obtained marks on OSCE examination out of 66 was 42.7. Among various components of OSCE, students scored high on rapport building. The most useful components of trainings were role-play, OSCE, and interaction with patients as per their feedback. CONCLUSION The intervention was found effective in increasing knowledge, changing attitude, and enhancing communication skills of medical students toward suicide prevention. Training of communication skills for suicide prevention in depressed person should be given to every medical student as suggested by feedback.
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Affiliation(s)
- Nimisha D Desai
- Department of Psychiatry, Gujarat Medical Education and Research Society Medical College, Gotri, Vadodara, India
| | - Paragkumar Chavda
- Department of Community Medicine, Gujarat Medical Education and Research Society Medical College, Gotri, Vadodara, India
| | - Sandeep H Shah
- Department of Psychiatry, Gujarat Medical Education and Research Society Medical College, Gotri, Vadodara, India
| | - Nilima Shah
- Department of Psychiatry, Smt N H L Municipal Medical College, Ahmedabad, Gujarat, India
| | - Saurabh N Shah
- Department of Psychiatry, Gujarat Medical Education and Research Society Medical College, Gotri, Vadodara, India
| | - Elavatsala Sharma
- Department of Psychiatry, Gujarat Medical Education and Research Society Medical College, Gotri, Vadodara, India
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Basu A, Chadda R, Sood M, Rizwan SA. Pre-treatment factor structures of the Montgomery and Åsberg Depression Rating scale as predictors of response to escitalopram in Indian patients with non-psychotic major depressive disorder. Asian J Psychiatr 2017; 28:154-159. [PMID: 28784374 DOI: 10.1016/j.ajp.2017.04.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 03/22/2017] [Accepted: 04/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Major Depressive Disorder (MDD) is a broad heterogeneous construct resolving into several symptom-clusters by factor analysis. The aim was to find the factor structures of MDD as per Montgomery and Asberg Depression Rating Scale (MADRS) and whether they predict escitalopram response. METHODS In a longitudinal study at a tertiary institute in north India, 116 adult out-patients with non-psychotic unipolar MDD were assessed with MADRS before and after treatment with escitalopram (10-20mg) over 6-8 weeks for drug response. RESULTS For total 116 patients pre-treatment four factor structures of MADRS extracted by principal component analysis with varimax rotation altogether explained a variance of 57%: first factor 'detachment' (concentration difficulty, lassitude, inability to feel); second factor 'psychic anxiety' (suicidal thoughts and inner tension); third 'mood-pessimism' (apparent sadness, reported sadness, pessimistic thoughts) and fourth 'vegetative' (decreased sleep, appetite). Eighty patients (68.9%) who completed the study had mean age 35.37±10.9 yrs, majority were male (57.5%), with mean pre-treatment MADRS score 28.77±5.18 and majority (65%) having moderate severity (MADRS <30). Among them 56 (70%) responded to escitalopram. At the end of the treatment there were significant changes in all the 4 factor structures (p<0.01). Vegetative function was an important predictor of response (p<0.01, odd's ratio: 1.3 [1.1-1.6] 95% CI). Melancholia significantly predicted non-response (p=0.04). CONCLUSIONS Non-psychotic unipolar major depression having moderate severity in north Indian patients as per MADRS resolved into four factor-structures all significantly improved with adequate escitalopram treatment. Understanding the factor structure is important as they can be important predictor of escitalopram response.
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Affiliation(s)
- Aniruddha Basu
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Rakesh Chadda
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Mamta Sood
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - S A Rizwan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India; Department of Community Medicine, Velammal Medical College Hospital & Research Institute, Velammal Village, Madurai-Tuticorin Ring Road, Madurai 625009, Tamil Nadu, India.
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Grover S, Dalla E, Mehra A, Chakrabarti S, Avasthi A. Physical Comorbidity and its Impact on Symptom Profile of Depression among Elderly Patients Attending Psychiatry Services of a Tertiary Care Hospital. Indian J Psychol Med 2017; 39:450-456. [PMID: 28852239 PMCID: PMC5559993 DOI: 10.4103/0253-7176.211764] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
AIM This study aimed to evaluate the prevalence of physical comorbidities among elderly patients with depression attending psychiatric services and the secondary aim of the study was to evaluate the influence of physical comorbidities on symptom profile of depression. METHODOLOGY 140 patients with a diagnosis of depression as per the International Classification of Diseases-10 criteria were evaluated on Geriatric Depression Scale (GDS) and a physical comorbidity checklist. RESULTS More than two-third (72.1%) of the patients had at least one physical illness. Out of those with physical comorbidity, more than half (57 out of 101) had at least 2 physical illnesses. The most commonly involved systems were cardiovascular system (n = 68; 48.6%), followed by endocrinological system (27.1%) and ophthalmological system (26.4%). Most common physical comorbidity was hypertension (47.14%), followed by cataract (25.7%) and diabetes mellitus (25%). The presence of any physical comorbidity, presence of hypertension or presence of diabetes mellitus did not influence the manifestations of depression as assessed by GDS-30. CONCLUSION Elderly patients with depression have high rates of physical comorbidities. Clinicians managing elderly patients with depression must get their patient thoroughly evaluated for the presence of various physical comorbidities.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Eish Dalla
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aseem Mehra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Lewis AJ, Rowland B, Tran A, Solomon RF, Patton GC, Catalano RF, Toumbourou JW. Adolescent depressive symptoms in India, Australia and USA: Exploratory Structural Equation Modelling of cross-national invariance and predictions by gender and age. J Affect Disord 2017; 212:150-159. [PMID: 28192764 DOI: 10.1016/j.jad.2017.01.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 01/11/2017] [Accepted: 01/19/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND The present study compares depressive symptoms in adolescents from three countries: Mumbai, India; Seattle, United States; and Melbourne, Australia measured using the Short Moods and Feelings Questionnaire (SMFQ). The study cross nationally compares SMFQ depressive symptom responses by age and gender. METHODS Data from a cross-nationally matched survey were used to compare factorial and measurement characteristics from samples of students from Grade 7 and 9 in Mumbai, India (n=3268) with the equivalent cohorts in the Washington State, USA (n=1907) and Victoria, Australia (n=1900). Exploratory Structural Equation Modelling (ESEM) was used to cross-nationally examine factor structure and measurement invariance. RESULTS A number of reports suggesting that SMFQ is uni-dimensional were not supported in findings from any country. A model with two factors was a better fit and suggested a first factor clustering symptoms that were affective and physiologically based symptoms and a second factor of self-critical, cognitive symptoms. The two-factor model showed convincing cross national configural invariance and acceptable measurement invariance. The present findings revealed that adolescents in Mumbai, India, reported substantially higher depressive symptoms in both factors, but particularly for the self-critical dimension, as compared to their peers in Australia and the USA and that males in Mumbai report high levels of depressive symptoms than females in Mumbai. LIMITATIONS the cross sectional study collected data for adolescents in Melbourne and Seattle in 2002 and the data for adolescents in Mumbai was obtained in 2010-2011 CONCLUSIONS: These findings suggest that previous findings in developed nations of higher depressive symptoms amongst females compared to males may have an important cultural component and cannot be generalised as a universal feature of adolescent development.
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Affiliation(s)
- Andrew J Lewis
- School of Psychology and Exercise Science Murdoch University, Perth, WA, Australia; Harry Perkins Medical Research Institute, Fiona Stanley Hospital, Perth, WA, Australia.
| | - Bosco Rowland
- School of Psychology, Faculty of Health Deakin University, Burwood, Victoria, Australia
| | - Aiden Tran
- Gatehouse Centre, Royal Children's Hospital, 50 Flemington Rd Parkville 3052, Victoria, Australia
| | - Renatti F Solomon
- School of Psychology and Exercise Science Murdoch University, Perth, WA, Australia; Department of Psychology, KBP College and Institute for Child and Adolescent Health Research, Mumbai, India
| | - George C Patton
- Murdoch Children's Research Institute, The Royal Children's Hospital Campus Melbourne, Centre for Adolescent Health, Victoria, Australia; The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Victoria, Australia
| | | | - John W Toumbourou
- School of Psychology, Faculty of Health Deakin University, Burwood, Victoria, Australia
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Chaudhuri SB, Mandal PK, Chakrabarty M, Bandyopadhyay G, Bhattacherjee S. A study on the prevalence of depression and its risk factors among adult population of Siliguri subdivision of Darjeeling district, West Bengal. J Family Med Prim Care 2017; 6:351-355. [PMID: 29302546 PMCID: PMC5749085 DOI: 10.4103/jfmpc.jfmpc_326_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Considering morbidity and mortality, depression is a burning issue in the modern civilization. Early diagnosis and treatment significantly reduces the incidence of morbidity and mortality. In this context, the present study was conducted to find the prevalence and associated factors of depression among adult population of Siliguri subdivision, Darjeeling district, West Bengal. MATERIALS AND METHODS A community-based cross-sectional study was conducted among adult population (≥18 years) of Siliguri subdivision of Darjeeling district, West Bengal. Thirty-cluster sampling method was used to identify the study participants. Beck's depression inventory-II was used as the screening tool. Binary logistic regression was done to find the associated factors of depression using IBM SPSS software Version 20.0 (Armonk, New York). RESULTS Overall, 36% of the study participants were depressed and 11% were significantly depressed. In binary logistic regression, female gender, rural resident, and lower educational status were found to be significantly associated with depression. CONCLUSION Screening of depression and early identification of associated factors helps in reducing the adverse outcome of depression. More than one-third of the population depressed and there were some modifiable associated factors such as educational status and rural residence.
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Affiliation(s)
- Sudip Banik Chaudhuri
- Department of Community Medicine, IQ City Medical College and Hospital, Durgapur, West Bengal, India
| | - Pankaj Kumar Mandal
- Department of Community Medicine, ID and BG Hospital, Kolkata, West Bengal, India
| | - Manasi Chakrabarty
- Department of Community Medicine, MGM Medical College, Kishanganj, Bihar, India
| | - Gautam Bandyopadhyay
- Department of Psychiatry, Sagar Dutta Medical College, Kolkata, West Bengal, India
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Indu PS, Anilkumar TV, Pisharody R, Russell PSS, Raju D, Sarma PS, Remadevi S, Amma KRLI, Sheelamoni A, Andrade C. Primary care Screening Questionnaire for Depression: reliability and validity of a new four-item tool. BJPsych Open 2017; 3:91-95. [PMID: 28446960 PMCID: PMC5388833 DOI: 10.1192/bjpo.bp.116.003053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 03/07/2017] [Accepted: 03/16/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Unidentified depression in primary care is a public health concern, globally. There is a need for brief, valid and easily administered tools in primary care. AIMS To estimate reliability and validity of the newly developed Primary care Screening Questionnaire for Depression (PSQ4D), a four-item tool, with 'yes' or 'no' options. METHOD PSQ4D was administered verbally (time required, <1 min) by primary care physicians to adult outpatients (n=827) in six primary care settings in Kerala, India. A psychiatrist evaluated each patient on the same day, using ICD-10 Diagnostic Criteria for Research, based on unstructured clinical interview. RESULTS The Cronbach's alpha for internal consistency reliability was 0.80; kappa coefficient for test-retest reliability was 0.9 and that for interrater reliability was 0.72. At a score ≥2, sensitivity was 0.96, specificity was 0.87, positive predictive value was 0.74, negative predictive value was 0.98, positive likelihood ratio was 7.4 and negative likelihood ratio was 0.05. CONCLUSIONS When physician administered, PSQ4D has good reliability. At a cut-off score of ≥2, it has high sensitivity and specificity to identify depressive disorder in primary care. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
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Affiliation(s)
| | | | - Ramdas Pisharody
- , MD, DM, Clinical Epidemiology Resource Training Centre, Government Medical College, Trivandrum, India
| | | | - Damodaran Raju
- , MD, Department of Psychiatry, Government Medical College, Trivandrum, India
| | - P Sankara Sarma
- , PhD, Department of Biostatistics, Achutha Menon Centre for Health Science Studies, Sree ChitraTirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Saradamma Remadevi
- , PhD, Medico-Sociology, Community Medicine, Government Medical College, Trivandrum, India
| | - K R Leela Itty Amma
- , MD, Department of Community Medicine, Government Medical College, Trivandrum, India
| | - A Sheelamoni
- , MD, PhD, Clinical Epidemiology Resource Training Centre, Government Medical College, Trivandrum, India
| | - Chittaranjan Andrade
- , MD, Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore, India
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Nahar P, Kannuri NK, Mikkilineni S, Murthy GVS, Phillimore P. mHealth and the management of chronic conditions in rural areas: a note of caution from southern India. Anthropol Med 2017; 24:1-16. [PMID: 28292206 PMCID: PMC5359738 DOI: 10.1080/13648470.2016.1263824] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article examines challenges facing implementation of likely mHealth programmes in rural India. Based on fieldwork in Andhra Pradesh in 2014, and taking as exemplars two chronic medical 'conditions' - type 2 diabetes and depression - we look at ways in which people in one rural area currently access medical treatment; we also explore how adults there currently use mobile phones in daily life, to gauge the realistic likelihood of uptake for possible mHealth initiatives. We identify the very different pathways to care for these two medical conditions, and we highlight the importance to the rural population of healthcare outside the formal health system provided by those known as registered medical practitioners (RMP), who despite their title are neither registered nor trained. We also show how limited is the use currently made of very basic mobile phones by the majority of the older adult population in this rural context. Not only may this inhibit mHealth potential in the near future; just as importantly, our data suggest how difficult it may be to identify a clinical partner for patients or their carers for any mHealth application designed to assist the management of chronic ill-health in rural India. Finally, we examine how the promotion of patient 'self-management' may not be as readily translated to a country like India as proponents of mHealth might assume.
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Affiliation(s)
- Papreen Nahar
- a Institute of Population Health, University of Manchester, Manchester , UK
| | | | | | - G V S Murthy
- b Indian Institute of Public Health , Hyderabad , India
| | - Peter Phillimore
- d School of Geography, Politics and Sociology , Newcastle University , Newcastle upon Tyne , UK
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Bayetti C, Jadhav S, Deshpande SN. How do psychiatrists in India construct their professional identity? A critical literature review. Indian J Psychiatry 2017; 59:27-38. [PMID: 28529358 PMCID: PMC5419009 DOI: 10.4103/psychiatry.indianjpsychiatry_16_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Psychiatric practice in India is marked by an increasing gulf between largely urban-based mental health professionals and a majority rural population. Based on the premise that any engagement is a mutually constructed humane process, an understanding of the culture of psychiatry including social process of local knowledge acquisition by trainee psychiatrists is critical. This paper reviews existing literature on training of psychiatrists in India, the cultural construction of their professional identities and autobiographical reflections. The results reveal a scarcity of research on how identities, knowledge, and values are constructed, contested, resisted, sustained, and operationalized through practice. This paper hypothesizes that psychiatric training and practice in India continues to operate chiefly in an instrumental fashion and bears a circular relationship between cultural, hierarchical training structures and patient-carer concerns. The absence of interpretative social science training generates a professional identity that predominantly focuses on the patient and his/her social world as the site of pathology. Infrequent and often superfluous critical cultural reflexivity gained through routine clinical practice further alienates professionals from patients, caregivers, and their own social landscapes. This results in a peculiar brand of theory and practice that is skewed toward a narrow understanding of what constitutes suffering. The authors argue that such omissions could be addressed through nuanced ethnographies on the professional development of psychiatrists during postgraduate training, including the political economies of their social institutions and local cultural landscapes. Further research will also help enhance culturally sensitive epistemology and shape locally responsive mental health training programs. This is critical for majority rural Indians who place their trust in State biomedical care.
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Affiliation(s)
- Clement Bayetti
- Division of Psychiatry, University College London, London WC1E 6BT, United Kingdom
| | - Sushrut Jadhav
- Division of Psychiatry, University College London, London WC1E 6BT, United Kingdom
| | - Smita N. Deshpande
- Department of Psychiatry, Centre of Excellence in Mental Health, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Gautam S, Jain A, Gautam M, Vahia VN, Grover S. Clinical Practice Guidelines for the management of Depression. Indian J Psychiatry 2017; 59:S34-S50. [PMID: 28216784 PMCID: PMC5310101 DOI: 10.4103/0019-5545.196973] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Shiv Gautam
- Director Professor, Director, Gautam Hospital & Research Center, Consultant Psychiatrist Gautam Hospital and Research Center, Jaipur, India
| | | | - Manaswi Gautam
- Gautam Hospital and Research Center and Gautam Institute of Behavioural Sciences and Alternative Medicine, Jaipur, India
| | - Vihang N Vahia
- Consultant Psychiatrist, Gaur Medical Health Clinic, Ajmer, India
| | - Sandeep Grover
- Additional Professor, Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Kato T. Relationship between coping flexibility and the risk of depression in Indian adults. Asian J Psychiatr 2016; 24:130-134. [PMID: 27931896 DOI: 10.1016/j.ajp.2016.09.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/01/2016] [Accepted: 09/01/2016] [Indexed: 11/17/2022]
Abstract
According to the dual-process theory of coping flexibility, coping flexibility is the ability to discontinue an ineffective coping strategy and produce and implement an alternative coping strategy. In order to test the coping flexibility hypothesis, which posits that flexible coping produces adaptive outcomes, the relationship between coping flexibility and the risk of depression was examined in the context of Indian adults. Participants (150 men and 150 women) answered questionnaires measuring coping flexibility and depressive symptoms. The risk of depression was assessed using a Patient Health Questionnaire-9 score of 10 and a Center for Epidemiologic Studies' Depression Scale score of 16 as cut-off points. Logistic regression analyses of the score cut-off points revealed that higher levels of coping flexibility were associated with lower risks of depression, after controlling for the effects of gender, age, and marital status. Overall, the coping flexibility hypothesis was supported in this Indian adult sample. These findings might contribute to preventing recurrent depression and to attenuating depressive symptoms.
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Affiliation(s)
- Tsukasa Kato
- Department of Social Psychology, Toyo University, 5-28-20 Hakusan, Bunkyo-ku, Tokyo 112-8606, Japan.
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Albers HM, Kinra S, Radha Krishna KV, Ben-Shlomo Y, Kuper H. Prevalence and severity of depressive symptoms in relation to rural-to-urban migration in India: a cross-sectional study. BMC Psychol 2016; 4:47. [PMID: 27654459 PMCID: PMC5031265 DOI: 10.1186/s40359-016-0152-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 09/07/2016] [Indexed: 11/10/2022] Open
Abstract
Background Migration is a major life event, which may also be a risk factor for depression. However, little is known regarding the relationship between these phenomena in low and middle income settings. This study explores the frequency and severity of depressive symptoms among rural-to-urban migrants compared to permanent rural and to urban residents in India. Methods We assessed 884 subjects; urban non-migrants (n = 159), urban migrants (n = 461) and rural non-migrants (n = 264) in Hyderabad, India, in 2009–2010. The frequency and severity of depressive symptoms was assessed with the validated Telugu version of the Brief Patient Health Questionnaire. Multivariable logistic regression was used to examine the association between the presence of depressive symptoms and migration status while adjusting for gender, age and several sociodemographic and health-related parameters using Stata v.12. Results The prevalence of mild to severe depressive symptoms was higher in women (11.3, 95 % confidence interval (CI) 8.3–14.3 %) compared to men (5.8 %, 95 % CI 3.7–7.9 %). Rural residents reported the highest prevalence of mild to severe depressive symptoms (women: 16.7 %, 95 % CI 9.8–23.5 %; men: 8.0 %, 95 % CI 3.7–12.3 %). Among women, the lowest prevalence was reported by migrants (8.2 %, 95 % CI 4.6–11.9 %). Among men, prevalence was similar in migrants (5.0 %, 95 % CI 2.2–7.7 %) and urban residents (3.9 %, 95 % CI 0–8.3 %). Multivariable logistic regression analyses showed no evidence for increased prevalence of mild to severe depressive symptoms among migrants compared to either rural or urban residents. Conclusions There was no evidence for an increased prevalence of mild to severe depressive symptoms among rural-urban migrants compared to rural or urban residents.
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Affiliation(s)
- Hannah Maike Albers
- Leibniz Institute for Prevention Research and Epidemiology-BIPS GmbH, Bremen, Germany.
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
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Soni A, Fahey N, Byatt N, Prabhakaran A, Moore Simas TA, Vankar J, Phatak A, O'Keefe E, Allison J, Nimbalkar S. Association of common mental disorder symptoms with health and healthcare factors among women in rural western India: results of a cross-sectional survey. BMJ Open 2016; 6:e010834. [PMID: 27388353 PMCID: PMC4947826 DOI: 10.1136/bmjopen-2015-010834] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Information about common mental disorders (CMD) is needed to guide policy and clinical interventions in low-income and middle-income countries. This study's purpose was to characterise the association of CMD symptoms with 3 inter-related health and healthcare factors among women from rural western India based on a representative, cross-sectional survey. SETTING Surveys were conducted in the waiting area of various outpatient clinics at a tertiary care hospital and in 16 rural villages in the Anand district of Gujarat, India. PARTICIPANTS 700 Gujarati-speaking women between the ages of 18-45 years who resided in the Anand district of Gujarat, India, were recruited in a quasi-randomised manner. PRIMARY AND SECONDARY OUTCOMES MEASURES CMD symptoms, ascertained using WHO's Self-Reporting Questionnaire-20 (SRQ-20), were associated with self-reported (1) number of healthcare visits in the prior year; (2) health status and (3) portion of yearly income expended on healthcare. RESULTS Data from 658 participants were used in this analysis; 19 surveys were excluded due to incompleteness, 18 surveys were excluded because the participants were visiting hospitalised patients and 5 surveys were classified as outliers. Overall, 155 (22·8%) participants screened positive for CMD symptoms (SRQ-20 score ≥8) with most (81.9%) not previously diagnosed despite contact with healthcare provider in the prior year. On adjusted analyses, screening positive for CMD symptoms was associated with worse category in self-reported health status (cumulative OR=9.39; 95% CI 5·97 to 14·76), higher portion of household income expended on healthcare (cumulative OR=2·31; 95% CL 1·52 to 3.52) and increased healthcare visits in the prior year (incidence rate ratio=1·24; 95% CI 1·07 to 1·44). CONCLUSIONS The high prevalence of potential CMD among women in rural India that is unrecognised and associated with adverse health and financial indicators highlights the individual and public health burden of CMD.
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Affiliation(s)
- Apurv Soni
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Nisha Fahey
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Des Moines University, Des Moines, Iowa, USA
| | - Nancy Byatt
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | | | | | | | - Ajay Phatak
- Pramukhswami Medical College, Karamsad, Gujarat, India
| | | | - Jeroan Allison
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Mushtaq R, Tarfarosh SFA, Dar MM, Hussain A, Shoib S, Shah T, Shah S, Manzoor M. Is there a link between Depressive Disorders and Tryptophan Hydroxylase 1 (TPH1) Gene Polymorphism? - Study from a Distressed Area, Kashmir (India). Cureus 2016; 8:e673. [PMID: 27672527 PMCID: PMC5028182 DOI: 10.7759/cureus.673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background The progress that man has made in all domains of life, during all these years of reign over the earth, is utterly remarkable. However, it always came at a price. Each epoch of progress has seen human beings inflicted with trauma and cynical consequences. During the last two decades, Kashmiri (Indian) people have experienced continuous violence, a reign of terror, and political turmoil. Each of these disastrous events has contributed to the increase in psychiatric disorders in this part of the world, especially major depressive disorders. We can observe that besides the environmental influences, gene polymorphism also plays a crucial role in the development of depressive disorders. The role of Tryptophan Hydroxylase 1 (TPH1) gene is implicated in various psychiatric disorders, including depression. However, no study has investigated TPH1 A779C gene polymorphism in depressive disorders in a distressed society like Kashmir (India). Aims To study TPH1 A779C single nucleotide polymorphism in depressive disorders in Kashmiri (Indian) population. Materials and Methods Two hundred and forty patients diagnosed with depressive disorder, and 160 unrelated healthy volunteers (control), were studied in a case-control study design. Polymorphism was determined using polymerase chain reaction (PCR) and agarose gel electrophoresis, after digestion with HAP II enzyme. Genotypes and allele frequencies were compared using Chi-square tests, Fisher’s exact test, odds ratio, 95% confidence interval (C.I.) and a p-value of <0.05 was considered to be statistically significant. Results The mean age ± standard deviation (SD) of depression and control group was 32.02±10.99 and 31.75±9.93, respectively (p= 0.512). It was found that the patients from depression group had AA genotype (51.7%) in comparison to control group (17.5%) and these results were statistically significant (p≤0.0001). Calculation of allelic frequency revealed a stronger association of A allele with depression group (70.83%) than with the control group (41.25%), and it was also found to be statistically significant (p≤0.0001) with C.I. of 3.459 (1.909-6.266). Conclusion TPH1 A779C A gene was found to be associated with a major depressive disorder (MDD) in Kashmiri (Indian) population. There were high HAM-A as well as HAM-D scores in depressive patients of Kashmir (India).
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Affiliation(s)
- Raheel Mushtaq
- Mood Disorder Clinic, Postgraduate Department of Psychiatry, Government Medical College, Srinagar, J & K, India
| | | | - Mohammad Maqbool Dar
- Postgraduate Department of Psychiatry, Government Medical College, Srinagar, J & K, India
| | - Arshad Hussain
- Postgraduate Department of Psychiatry, Government Medical College, Srinagar, J & K, India
| | - Sheikh Shoib
- Mood Disorder Clinic, Postgraduate Department of Psychiatry, Government Medical College, Srinagar, J & K, India
| | - Tabindah Shah
- MBBS, Government Medical College, Srinagar, J & K, India
| | - Sahil Shah
- MBBS, Acharya Shri Chander College of Medical Sciences and Hospital, Sidhra, J & K, India
| | - Mushbiq Manzoor
- MBBS, Sheri Kashmir Institute of Medical Sciences Medical College, Srinagar, India
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Mathias K, Goicolea I, Kermode M, Singh L, Shidhaye R, Sebastian MS. Cross-sectional study of depression and help-seeking in Uttarakhand, North India. BMJ Open 2015; 5:e008992. [PMID: 26589428 PMCID: PMC4663438 DOI: 10.1136/bmjopen-2015-008992] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study sought to use a population-based cross-sectional survey to describe depression prevalence, healthcare seeking and associations with socioeconomic determinants in a district in North India. SETTING This study was conducted in Sahaspur and Raipur, administrative blocks of Dehradun district, Uttarakhand, in July 2014. PARTICIPANTS A population-based sample of 960 people over the age of 18 years was selected in 30 randomised clusters after being stratified by rural:urban census ratios. PRIMARY OUTCOME MEASURES The survey used a validated screening tool, Patient Health Questionnaire, to identify people with depression, and collected information regarding socioeconomic variables and help-seeking behaviours. Depression prevalence and health seeking behaviours were calculated, and multivariable logistic regression was used to assess associations between risk factors and depression. RESULTS Prevalence of depression was 6% (58/960), with a further 3.9% (37/960) describing a depressive episode of over 2 weeks in the past 12 months. Statistically significant adjusted OR for depression of more than 2 were found for people who were illiterate, classified as Scheduled Caste/Tribe or Other Backward Castes, living in temporary material housing and who had recently taken a loan. While over three quarters of people with depression (79%) had attended a private or government general medical practitioner in the past 3 months, none had received talking therapy (100% treatment gap) and two people (3.3%) had been prescribed antidepressants. CONCLUSIONS There are clear associations between social, educational and economic disadvantage and depression in this population. Strategies that address the social determinants of depression, such as education, social exclusion, financial protection and affordable housing for all are indicated. To address the large treatment gap in Uttarakhand, we must ensure access to primary and secondary mental health providers who can recognise and appropriately manage depression.
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Affiliation(s)
- Kaaren Mathias
- Department of Community Health and Development, Emmanuel Hospital Association, New Delhi, India
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Isabel Goicolea
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Michelle Kermode
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Rahul Shidhaye
- Centre for Mental Health, Public Health Foundation of India, New Delhi, India
| | - Miguel San Sebastian
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Santos CAD, Ribeiro AQ, Rosa CDOB, Ribeiro RDCL. Depressão, déficit cognitivo e fatores associados à desnutrição em idosos com câncer. CIENCIA & SAUDE COLETIVA 2015; 20:751-60. [DOI: 10.1590/1413-81232015203.06252014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 08/26/2014] [Indexed: 11/21/2022] Open
Abstract
Objetiva-se analisar a presença de depressão, a função cognitiva, o estado nutricional e os fatores associados à desnutrição em idosos em tratamento para o câncer. Foi realizado um estudo transversal em um centro oncológico em Minas Gerais que incluiu a aplicação de um questionário sociodemográfico e de saúde, a avaliação de sintomas depressivos, da função cognitiva e do estado nutricional. Foram avaliados 96 idosos, 50% do sexo feminino e com idade média de 70,6 anos. O déficit cognitivo foi identificado em 39,6% e a presença de depressão em 17,7% dos avaliados, com um maior número de sintomas depressivos sexo feminino (p = 0,017). Foi diagnosticada desnutrição moderada ou suspeita de desnutrição em 29,2% dos avaliados, desnutrição grave em 14,6% e 47,9% apresentou necessidade de intervenção nutricional crítica. Na análise multivariada foram condições independentemente associadas à desnutrição o déficit funcional (RP: 3,40; IC: 1,23-9,45), a presença de dois ou mais sintomas de impacto nutricional (RP: 3,22; IC: 1,03-10,10) e o tratamento atual por quimioterapia (RP: 2,96; IC: 1,16-7,56). Idosos com câncer apresentaram elevada prevalência de desnutrição e de necessidade de intervenção nutricional. A avaliação da depressão e do déficit cognitivo também devem ser partes integrantes na abordagem deste grupo.
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Singh H, Raju MSVK, Dubey V, Kurrey R, Bansal S, Malik M. A study of sociodemographic clinical and glycemic control factors associated with co-morbid depression in type 2 diabetes mellitus. Ind Psychiatry J 2014; 23:134-42. [PMID: 25788803 PMCID: PMC4361976 DOI: 10.4103/0972-6748.151687] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
CONTEXT Diabetes affects 9.2% of adults in India. About 8-16% of its population also suffer from depression. Both diseases pose a serious health challenge at individual and system level. The prevalence of depression in diabetes is much higher than in the general population. Undiagnosed and untreated depression puts people at higher morbidity and mortality risk. AIM To study the prevalence of depression in diabetes and to identify associated risk factors. SETTINGS AND DESIGN Case control study carried out in an outpatient setting of a tertiary hospital in central India. MATERIALS AND METHODS One hundred and nine type 2 diabetes patients and 91 healthy controls formed the subjects of the study. Sociodemographic data were obtained on seven parameters. Comprehensive clinical data were obtained by means of standard procedures. Blood sugar levels and glycosylated hemoglobin levels were measured to assess glycemic control. Data of diabetic patients and controls as well as that of depressed and nondepressed diabetics were subjected to statistical analysis. RESULTS About 42.2% of diabetes patients and only 4.39% of controls had depression. About 19% of diabetics had peripheral neuropathy but had much higher neuropathic symptoms. Depression was not related to any sociodemographic or clinical factors but was strongly associated with poor glycemic control. CONCLUSION Depression is highly prevalent in diabetes. Physical symptoms mask depression. Special attention needs to be paid to diagnose depression in diabetes and treat it appropriately along with effective glycemic control. Diabetes patients need to be treated collaboratively by physicians and psychiatrists.
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Affiliation(s)
- Hritu Singh
- Department of Psychiatry, Peoples College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - M S V K Raju
- Department of Psychiatry, Peoples College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Vaibhav Dubey
- Department of Psychiatry, Peoples College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Ravindra Kurrey
- Department of Psychiatry, Peoples College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Shaifali Bansal
- Department of Medicine, Peoples College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Mustafa Malik
- Department of Medicine, Peoples College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
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Sathyanarayana Rao TS, Darshan MS, Tandon A, Raman R, Karthik KN, Saraswathi N, Das K, Harsha GT, Krishna VST, Ashok NC. Suttur study: An epidemiological study of psychiatric disorders in south Indian rural population. Indian J Psychiatry 2014; 56:238-45. [PMID: 25316934 PMCID: PMC4181178 DOI: 10.4103/0019-5545.140618] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Based on review of literature World Health Organization (WHO) Global Burden of Disease Study has estimated that psychiatric disorders are among the most burdensome, around the globe and has suggested general population surveys for future research. This study aims to estimate the prevalence of psychiatric disorders and study their association with various socioeconomic variables. MATERIALS AND METHODS This was an exploratory study where a door-to-door survey of the entire population residing in a South Indian village was done (n = 3033). Mini international neuropsychiatric interview kid (MINI) or MINI plus were administered to all the subjects according to the age group. RESULTS It was found that 24.40% of the subjects were suffering from one or more diagnosable psychiatric disorder. Prevalence of depressive disorders was found to be 14.82% and of anxiety disorders was 4%. Alcohol dependence syndrome was diagnosed in 3.95% of the population. Prevalence of dementia in subjects above 60 years was found to be 10%. CONCLUSION Our study is among the very few epidemiological studies with respect to methodological design which does not use screening questionnaires and evaluates each subject with detailed administration of MINI. It concluded that one among four were suffering from a psychiatric disorder. Improving the training of undergraduate medical and nursing students is likely to play a significant role in addressing the increasing psychiatric morbidities.
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Affiliation(s)
| | - M. S. Darshan
- Department of Psychiatry, JSS Medical College, JSS University, Mysore, India
| | - Abhinav Tandon
- Department of Psychiatry, JSS Medical College, JSS University, Mysore, India
| | - Rajesh Raman
- Department of Psychiatry, JSS Medical College, JSS University, Mysore, India
| | - K. N. Karthik
- Department of Psychiatry, JSS Medical College, JSS University, Mysore, India
| | - N. Saraswathi
- Department of Psychiatry, JSS Medical College, JSS University, Mysore, India
| | - Keya Das
- Department of Psychiatry, JSS Medical College, JSS University, Mysore, India
| | - G. T. Harsha
- Department of Psychiatry, JSS Medical College, JSS University, Mysore, India
| | - V. S. T. Krishna
- Department of Psychiatry, JSS Medical College, JSS University, Mysore, India
| | - N. C. Ashok
- Department of Community Medicine, JSS Medical College, JSS University, Mysore, India
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Dhingra D, Bansal Y. Antidepressant-like activity of beta-carotene in unstressed and chronic unpredictable mild stressed mice. J Funct Foods 2014. [DOI: 10.1016/j.jff.2014.01.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Karve AV, Jagtiani SS, Chitnis KA. Evaluation of effect of allopurinol and febuxostat in behavioral model of depression in mice. Indian J Pharmacol 2014; 45:244-7. [PMID: 23833366 PMCID: PMC3696294 DOI: 10.4103/0253-7613.111922] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 01/18/2013] [Accepted: 02/26/2013] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate the effects of allopurinol and febuxostat on depression using Forced Swim Test (FST) in mice. MATERIALS AND METHODS Allopurinol (39 mg/kg p. o) and febuxostat (15.6 mg/kg p. o) were administered once daily for 21 successive days to Swiss Albino mice. On the 21(st) day, the effect of the drug on locomotion was tested using photo-actometer followed by the recording of immobility period in the FST and the results were compared with the standard drug fluoxetine (10 mg/kg p. o). RESULTS Allopurinol and febuxostat expressed significant antidepressant like effect as indicated by reduction in the immobility period of mice in the FST as compared to control group. The effects of allopurinol and febuxostat were found to be comparable to that of fluoxetine. CONCLUSION The results of the present study indicate that allopurinol and febuxostat possess significant antidepressant like activity.
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Affiliation(s)
- Ashwini V Karve
- Department of Pharmacology, T.N. Medical College and B.Y.L. Nair Ch. Hospital, Mumbai, Maharashtra, India
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