Indian Journal of Psychological Medicine最新文献

Background: The present study was designed to investigate the MMP9 genetic variants (rs20544 and rs17576) and plasma MMP9 in patients with schizophrenia spectrum disorders and their relation with cognition and suicide attempt.

Methods: The study comprises 216 patients with schizophrenia spectrum disorders and 216 age-matched controls. MMP-9 genetic variants were genotyped using a TaqMan Allelic Discrimination assay in schizophrenia and controls. Addenbrooke's Cognitive Examination III (ACE-III) scores were used to evaluate cognitive status. Suicidal ideation was assessed using the Columbia suicide severity rating (CSSR) scores. The genetic data were analyzed using the χ ² test, and plasma MMP-9 levels were compared across schizophrenia genotypes using the Kruskal-Wallis test.

Results: The GG variant (OR: 1.99, 95% CI: 1.182-3.38, p = .007), AG variant (OR: 1.76, 95% CI: 1.101-2.823, p = .01) and G allele (OR: 1.45, 95% CI: 1.11-1.90, p = .004) of rs17576 showed higher frequency in patients with schizophrenia in comparison with controls. The CC genotype variant (OR: 0.4916, 95% CI: 0.2723-0.8874, p = .01) and the C allele (OR: 0.776, 95% CI: 0.580-1.021, p = .04) of rs20544 showed lower frequencies in patients with schizophrenia compared with controls. Plasma MMP9 levels were higher in TT (p = .01) and CT genotypes (p = .01) in comparison with the CC genotype of rs20544 in schizophrenia. Plasma MMP-9 levels were not significantly different among genotypes of the rs17576 variant.

Conclusion: We conclude that the MMP9 genetic variants were associated with schizophrenia spectrum disorders, but not with cognitive impairment and suicide attempt.

Background: In India, an estimated 3.5 million are affected with schizophrenia, of which more than two-thirds belong to the rural demography. Schizophrenia is one of the most disabling illnesses, causing 10% of the disability adjusted life years, making it a public health concern. We aimed to estimate the treatment gap for schizophrenia in a rural South Indian setting following a community intervention program implemented in two administrative blocks (Thirthahalli and Turuvekere) in the state of Karnataka, India.

Methods: Population-based screening was conducted by trained Accredited Social Health Activists (ASHAs) to identify persons with symptoms of schizophrenia. Research social workers and psychiatrists interviewed screen-positives to confirm the diagnosis. Prevalent cases were enumerated by adding those already registered under the program to those newly identified through house-to-house screening. The treatment gap was calculated by subtracting the "target population" from those who had received psychiatric treatment at least once.

Results: In Thirthahalli, of 364 patients, 14 had not received any treatment, indicating a treatment gap of 3.84%. In Turuvekere, out of 236 cases, 29 had not received treatment, indicating a treatment gap of 12.28%. Overall, the treatment gap in both administrative blocks was 7.16%.

Conclusion: Meaningful reduction of treatment gap for schizophrenia is a feasible target at sub-district levels. Policies commensurate with this aim should be considered.

Background: Young adulthood (18-25 years) represents a critical developmental stage marked by heightened vulnerability to psychiatric disorders. Despite this, there is limited data on the clinical and demographic profiles of young adults seeking mental health care in India. This study analyzed trends and associations in the demographic and clinical characteristics of young adults participating in Collaborative Video Consultations (CVCs) at Primary Healthcare Centers (PHCs) across nine Indian states.

Methods: Data from 120 CVCs conducted between November 2022 and September 2024 were analyzed. Patients aged 18-25 were assessed using intake forms, clinical evaluations, and self-reports. Diagnoses included Common Mental Disorders (CMDs), Severe Mental Disorders (SMDs), Substance Use Disorders (SUDs), and other conditions. Associations between demographic factors, sleep disturbances, Deliberate Self-Harm (DSH), and diagnostic categories were explored.

Results: CMDs, predominantly depression and anxiety, were the most frequent diagnoses. Females were more likely to be diagnosed with CMDs, while males had higher rates of SUDs. Occupation showed significant associations: CMDs were common among students, SMDs among non-earning individuals, and SUDs among earning individuals. Sleep disturbances were significantly associated with CMDs (p < .001). DSH was also prevalent in CMDs (p = .003).

Conclusion: The findings underscore the clinical significance of early detection and gender-sensitive, occupation-specific mental health screenings at PHCs for young adults. Expanding teleconsultation models, such as CVCs, could help bridge care gaps for underserved populations.

Background: Experiences of childhood trauma in early years can have a devastating effect on an individual. Such experiences can often lead to difficulty developing healthy relationships and, in turn, influence relationships in adulthood. Understanding the relationship between such adverse experiences and attachment styles among prisoners, a population that is often neglected by society, is essential and, therefore, was the driving factor to conduct this study. The current study aimed at exploring the link between early traumatic experiences and perceived attachment styles among Indian prisoners.

Methods: A cross-sectional study design was used to collect data from prisons in the North and West regions of India. A sample of 200 prisoners (184 males, 16 females) aged 18-60 years was included in the study. The measures included the Childhood Trauma Questionnaire, Revised Adult Attachment Scale, and Modified Kuppuswamy Socioeconomic Index.

Results: Descriptive analysis revealed key socio-demographic characteristics of the participants. Neglect was observed to be more prevalent than other forms of abuse. Significant correlation was obtained between trauma and perceived attachment styles. Regression analysis indicated emotional abuse as a strong predictor of attachment-related anxiety and difficulty depending on others. Prisoners with fearful and preoccupied attachment styles reported greater exposure to physical abuse than those with a secure attachment style.

Conclusions: Our study provides preliminary highlights on the complex interplay between different forms of childhood trauma and their influence on adult attachment dimensions, highlighting the relevance of developing individualistic-based intervention strategies for prisoners to better aid in their rehabilitation.

Purpose of the review: Multi-morbidity, the coexistence of two or more chronic illnesses, is also increasing among older adults in the ageing world. The estimated prevalence of depression is 21.14% in persons with multi-morbidity compared to 3.91% in those without any chronic illness. As there was no data particularly for older adults with multi-morbidity, it was decided to conduct a systematic review of rates of depression.

Collection and analysis of data: This PROSPERO-registered study adhered to PRISMA guidelines. Searches for cross-sectional and population-based studies in the previous ten-year period (2014-2023) in databases and search engines, namely PubMed, Ovid MEDLINE, and PsycINFO, were conducted. Results: From an initial pool of 555 papers, 15 moderate-to-high quality studies were included for the systematic review, of which 10 were eligible for meta-analysis. The pooled prevalence of depression was 46.7% (95% CI = 33.8%-57.4%) for six studies with individuals aged 60 years and above and 12.9% (95% CI = 5.7%-51.5%) for four studies focusing on those aged 65 years or above. Due to variations in defining the age cut-off of 60 and 65 years for older adults, separate analyses were performed.

Conclusions: Findings reveal that nearly half of older adults with multi-morbidity experience depression. This highlights the importance of the timely detection of depression in general hospitals and primary care settings.

Background: For persons with mental illnesses (PWMI), mental capacity (MC) refers to their ability to perceive, choose, and articulate their treatment options. An advance directive (AD) is a declaration stating a person's wishes for care if their mental condition renders them handicapped. It also permits them to designate a nominated representative (NR) to assist them in making treatment-related decisions. The study aimed to ascertain the MC for treatment decisions, including admission of Indian PWMI, and analyze their AD.

Methods: This was a descriptive, exploratory, cross-sectional study involving 74 PWMI. The Clinical Global Impression-Severity (CGI-S) scale, "Capacity Assessment for Treatment Decisions Including Admission," the Bengaluru Advanced Directive Interview (BADI), and the Insight and Treatment Attitudes Questionnaire (ITAQ) were used to assess the severity of illness, MC, AD, and insight, respectively.

Results: The majority of PWMI (N = 66, 89.18%) had MC and were able to make choices regarding their admission, care, and treatment for mental health issues. Twelve patients who did not receive AD for treatment believed that in the future, they would never have any mental illness. The MC was significantly related to gender and insight (p values .020 and .001, respectively). Regarding AD, patients predominantly chose outpatient care (55.38%) and management by psychiatrists (78.38%) over other treatment providers. Mainly, parents (55.4%) were selected as NRs.

Conclusions: The majority of the Indian PWMI had MC and provided AD. The MC was significantly related to insight. According to current regulations, when providing care for PWMI, MC, and AD should be routinely assessed and documented.