Indian Journal of Psychiatry最新文献

Background: Functional near-infrared spectroscopy (fNIRS) is being increasingly utilized to visualize the brain areas involved in cognitive activity to understand the human brain better. Its portability and easy setup give it an advantage over other functional brain imaging tools. The current study utilizes fNIRS while performing a Stroop test, which is commonly used to assess the impairment of information selection in depression.

Aim: To compare cortical activation during the Stroop test in depressed individuals to healthy controls.

Methods: This cross-sectional study compared oxyhemoglobin (OxyHb) concentration changes in 39 individuals with depression to 40 healthy individuals. The Stroop test was construed in an event-related design with an intertrial interval of 2 seconds with jitter. A continuous wave fNIRS system was used for recording the cortical activity at 17 locations. Analysis of fNIRS data was done using statistical parametric mapping (SPM) for estimating general linear model (GLM) coefficients. Further analysis of the mean change of OxyHb concentrations during the 2 seconds after the presentation of congruent and incongruent stimuli was done between the groups using Mann-Whitney U test corrected for multiple comparisons with Bonferroni correction.

Results: While the number of errors and correct responses were similar between the groups, the reaction time for correct responses was more in the depression group in comparison to healthy individuals (t = -2.39, P = 0.01). For both healthy and depressive individuals in incongruent versus congruent task contrast, deactivation was seen in the region between the left middle frontal sulcus and frontopolar area of the brain (t = 0.41 and t = 0.21, respectively, P < 0.05). The depressed group had a higher mean change in OxyHb concentration following incongruent stimuli in comparison to the HCs (mean rank: HC = 32.63, depression = 47.56).

Conclusion: Our findings indicate that individuals with depression exhibited prolonged reaction times and distinct activation patterns of the frontal cortex compared to healthy individuals. The observed pattern of brain activation for congruent and incongruent tasks among both healthy and depressed individuals aligns with the findings of the prior studies, emphasizing the utility of fNIRS as a valuable instrument for assessing brain activity.

Nationa Medical Commission (NMC) had recently undertook the revision of Undergraduate CBME curriculum. the Authors were involved in Psychiatry curriculum revision. In this paper, authors explain the process of revision, the rationale behind the changes made and make specific suggestions for the better implementation of the revised curriculum.

Background: Schizophrenia is considered to be a condition that usually manifests at any age but commonly seen in young people and is associated with a genetic propensity in brain development.

Aim: The study explores the impact of aerobic training on brain architecture, hippocampal volume, cardiorespiratory parameters, and quality of life in young individuals with schizophrenia. The investigation focuses on the correlation between genetic predisposition, hippocampal atrophy, and diminished cardiorespiratory fitness, aiming to discern potential benefits of aerobic exercise on both physical and mental health outcomes.

Methods: A systematic search was conducted in major online databases, such as Cochrane, Embase, PEDro, Web of science and PubMed (Medline). Two authors independently evaluated possibilities of bias, retrieved data and decided which trials should be included in the analysis. Total of 13 published articles (randomized clinical and controlled trials) with 656 patients was included from January 2010 to December 2020.

Results: Following aerobic exercise training, people with schizophrenia presented with an increased hippocampus volume and enhanced cardiorespiratory endurance (P ˂0.05). Due to a lack of information, we rated the majority of the studies' risk of bias in relation to random sequence creation, allocation concealment, and selective reporting as uncertain.

Conclusion: Findings from the present review propose aerobic exercise program as a meaningful therapeutic intervention for schizophrenia patients in terms of maintaining appropriate brain architecture, increasing the hippocampal volume, improving cardiorespiratory parameters and health related quality of life.

Background: There is lack of data on bipolar disorder (BD) type II from India.

Aim: To compare the demographic and clinical characteristics of patients with BD-I and BD-II using the data of the Bipolar Disorder Course and Outcome study from India (BiD-CoIN study).

Methodology: Using the data of the BiD-CoIN study, patients with BD-I and BD-II were compared for demographic and clinical variables.

Results: Out of the 773 patients, 59 (7.63%) participants had BD-II. Compared to BD-I, patients with BD-II had a higher income; were more often unemployed or housewives; had a higher mean number of episodes per year of illness, higher severity of depressive episodes, higher depressive affective morbidity, and a higher number of hypomanic episodes (in the lifetime, and number of episodes per year of illness); received lower doses of lithium and a lower number of medications; and had lower prevalence of alcohol dependence, higher prevalence of seasonality, a high proportion of them sought faith healing treatment, and a higher proportion of them have predominant depressive polarity.

Conclusions: Patients with BD-I and BD-II differ from each other on certain demographic and clinical variables. The difference in the clinical variables suggests that the patients with BD-II may require different treatment approaches for management.

Background: First responders are at high risk for adverse mental health outcomes following trauma exposure during disaster response. This mixed methods study aimed to quantify psychological impacts and explore personal experiences among first responders after the Bahanaga train accident that killed 294 passengers in the month of June 2023.

Methods: For qualitative data, in-depth interviews (IDIs) were conducted, and quantitative data was collected using the PTSD checklist for DSM-5 (PCL-5), generalized anxiety disorder scale (GAD-7), and patient health questionnaire (PHQ-9) for symptoms of post-traumatic stress disorder (PTSD), depression, and anxiety. The study was conducted over one month during July 2023.

Results: Among 225 responders, alarming rates of symptoms of probable PTSD (10.2%), anxiety (11.6%), and depression (24.9%) were noted. Those with no prior exposure to disasters and those with no formal training in disaster response scored higher in measures for PTSD. IDIs were conducted with 22 first responders, including various stakeholders. Qualitative analysis identified themes of preoccupation with witnessing trauma, feeling overwhelmed, scary and terrible emotions, avoidance, guilt, hypervigilance, intrusive memories, emotional numbing, unmet needs for mental health support, worsening physical health, re-emergence of past traumas, compounding impact of graphic images in the media, certain positive impact, including increased empathy, resilience and finding purpose, and the beneficial role of peer support.

Conclusion: Significant psychological impacts are noted with elevated rates of probable PTSD, anxiety, and depressive symptoms among first responders one month after the Bahanaga train tragedy. These results underscore the vulnerability of first responders to mental health challenges following disaster response in India.