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Bhargav H, Eiman N, Jasti N, More P, Kumar V, Holla B, Arasappa R, Rao NP, Varambally S, Gangadhar B, Keshavan MS. Composition of yoga-philosophy based mental traits ( Gunas) in major psychiatric disorders: A trans-diagnostic approach. Front Psychol 2023; 14:1075060. [PMID: 36818072 PMCID: PMC9930472 DOI: 10.3389/fpsyg.2023.1075060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/04/2023] [Indexed: 02/04/2023] Open
Abstract
Yoga philosophy includes the theory of Tri-guna (three mental traits): sattva (signifies a tendency to 'goodness'), rajas (tendency towards 'activity'), and tamas (tendency towards "inertia"). This cross-sectional study aimed to understand the differences in the expression of gunas in patients suffering from major psychiatric disorders (n = 113, 40 females) and age-gender-education-matched healthy controls (HCs; n = 113, 40 females). Patients were diagnosed by a psychiatrist using DSM 5 criteria and suffered from the following disorders: depression (n = 30), schizophrenia (SCZ; n = 28), obsessive-compulsive disorder (OCD; n = 23), anxiety (n = 16), and bipolar affective disorder (BPAD; n = 16). Tri-gunas were assessed using a validated tool (Vedic Personality Inventory) and symptoms were assessed using standard scales as per the diagnosis. Multi-variate analysis of variance (MANOVA) was used to assess the differences in guna scores between HCs and patients, and between patients with different diagnoses. A two-tailed Pearson correlation was performed between the gunas and psychometric scales. Results revealed that HCs had significantly higher sattva traits as compared to patients (except those with OCD). Each psychiatric diagnosis also showed a specific guna configuration: (1) Anxiety disorders and OCD: High sattva-rajas, low tamas; (2) Depression: High sattva-tamas, low rajas; (3) Psychotic disorders (SCZ/BPAD): High tamo-rajas, low sattva. Significant positive correlations were observed between rajas traits and anxiety/OC/positive psychotic symptoms, negative psychotic symptoms and tamas traits, and sattva traits and OC symptoms. This finding has clinical implications, both to develop ways of predicting outcomes of psychiatric disorders, as well as to develop psycho-therapeutic and lifestyle interventions targeting the gunas.
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Affiliation(s)
- Hemant Bhargav
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India,*Correspondence: Hemant Bhargav, ✉
| | - Najla Eiman
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Nishitha Jasti
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pooja More
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Vinod Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Bharath Holla
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Rashmi Arasappa
- Massachusetts Mental Health Center, Boston, MA, United States
| | - Naren P. Rao
- Massachusetts Mental Health Center, Boston, MA, United States
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - B.N. Gangadhar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Matcheri S. Keshavan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
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Eiman N, Raman R, Mothi SN, Sathyanaryana Rao TS, Khan NA, Kunusegaran V, Krishnan RT. Assessment of neurological soft signs in pediatric patients with HIV infection. Indian J Psychiatry 2018; 60:229-235. [PMID: 30166681 PMCID: PMC6102969 DOI: 10.4103/psychiatry.indianjpsychiatry_283_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Children and adolescents comprise a significant proportion of people living with HIV. The effects of HIV on the growing brain have generated interest among researchers in this field. Deficits arising during this crucial phase of neuromaturation due to HIV infection need to be assessed and addressed. Neurological soft signs (NSSs) can act as a proxy marker for underlying neuropsychological deficits. The present study aims to study the NSSs in pediatric patients with HIV and compare with healthy controls (HCs). MATERIALS AND METHODS Forty-eight children aged between 6 and 16 years diagnosed with HIV were selected by purposive sampling, and the Physical and Neurological Examination of Soft Signs (PANESS) scale was applied. Fifty children matched by age and sex were recruited from a nearby school, and the PANESS scale was applied. Children were divided into age- and gender-specific groups. The outcome scores of cases and controls groups were compared. RESULTS Males and females aged 13-16 years with HIV showed more soft signs as compared to HCs, with respect to gait errors, dysrhythmia, impersistence, speed of repetitive and sequenced movements, overflow with gaits, overflow with sequenced movements, total overflow, and overflow in excess of age. The differences in scores were less marked in younger age groups among both the genders. CONCLUSIONS The persistence of NSSs in older age group in HIV-infected children may point toward the presence of HIV-associated neurological disorder.
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Affiliation(s)
- Najla Eiman
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
| | - Rajesh Raman
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
| | - S N Mothi
- Department of Pediatrics, Asha Kiran Charitable Trust, Mysore, Karnataka, India
| | - T S Sathyanaryana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
| | - Nawab Akhtar Khan
- Department of Clinical Psychology, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
| | | | - R Tharun Krishnan
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
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Ram D, Gowdappa B, Ashoka HG, Eiman N. Psychopharmacoteratophobia: Excessive fear of malformation associated with prescribing psychotropic drugs during pregnancy: An Indian perspective. Indian J Pharmacol 2016; 47:484-90. [PMID: 26600635 PMCID: PMC4621667 DOI: 10.4103/0253-7613.165186] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
“Psychopharmacoteratophobia is the fear or avoidance of prescribing psychotropic medicine to a pregnant woman on a given indication in anticipation of fetal malformation.” It is rooted in the tragedy associated with thalidomide use and is increasing due to the inability to predict accurately, strict legal provision of consumer protection, ethical and legal issues involved, and pitfalls in the available evidence of teratogenicity. In the Indian setting, the physicians face more challenges as the majority of the patients may ask them to decide, what is the best for their health. Most guidelines emphasize more on what not to do than what to do, and the locus of decision is left to the doctor and the patient. In this review, we have focused on relevant issues related to psychopharmacoteraophobia that may be helpful to understand this phenomenon and help to address the deprivation of a mentally ill woman from the required treatment.
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Affiliation(s)
- Dushad Ram
- Department of Psychiatry, JSS Medical College, JSS University, Mysore, Karnataka, India
| | - Basavnna Gowdappa
- Department of Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India
| | - H G Ashoka
- Department of Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India
| | - Najla Eiman
- Department of Psychiatry, JSS Medical College, JSS University, Mysore, Karnataka, India
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Ram D, Eiman N, Gowdappa B. Multimodal Hallucination (Audio-visual, Kinaesthetic and Scenic) Associated with the Use of Zolpidem. Clin Psychopharmacol Neurosci 2015; 13:215-7. [PMID: 26243852 PMCID: PMC4540046 DOI: 10.9758/cpn.2015.13.2.215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 02/12/2015] [Accepted: 02/13/2015] [Indexed: 11/18/2022]
Abstract
We are reporting a case of zolpidem induced multimodal hallucinations in a 22 year old female without any history of psychiatric disorders. Zolpidem, by acting on gamma-amino butyric acid type A receptor has a potential to cause a paradoxical reaction and there also exists a possibility of an induced delirium with its use. This case reports evaluates its potential to cause multimodal hallucinations. Zolpidem needs to be prescribed judiciously with the caution of potential side effects particularly in females.
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Affiliation(s)
- Dushad Ram
- Departments of Psychiatry, JSS Medical College, Mysore, India
| | - Najla Eiman
- Departments of Psychiatry, JSS Medical College, Mysore, India
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