Indian Journal of Psychological Medicine最新文献

Background: Facial emotion recognition is one of the significant domains of social cognition that underlie social interactions. These deficits can influence the functional outcome in individuals with schizophrenia by impairing judgment toward others and reducing their capability to function. We aimed to assess the facial emotion recognition deficits in individuals with schizophrenia in comparison to healthy individuals and find their association with clinical and demographic profiles.

Methods: This cross-sectional study compared individuals with schizophrenia in a stable remitted phase of illness to an age, gender, and education-matched healthy population, including 30 participants in each group. The assessment was done using Addenbrooke's Cognitive Examination (ACE-III), AIIMS Facial Toolbox for Emotion Recognition (AFTER), and the Positive and Negative Syndrome Scale (PANSS). Intergroup comparison was done using the Independent sample t-test, and the association of facial emotional deficit with any clinical or demographic factor was analyzed using Pearson's correlation.

Results: The schizophrenia group performed significantly worse than healthy controls on identifying positive and negative emotions except for happiness. The time to recognize emotion was also found to be significantly more in the schizophrenia group than in controls. Also, significant cognitive deficits were found in the schizophrenia group in comparison to the healthy population. Negative emotions were found to be more correlated to psychopathology.

Conclusion: Individuals with schizophrenia appear to have a stable deficit in facial emotion recognition (more in negative emotions). Cognitive deficits are seen more in individuals with schizophrenia as compared to healthy populations, even in their stable phase of illness.

Background: Adolescents are susceptible to using tobacco because of early exposure to tobacco through family members, easy access, or peer pressure. School-based educational programs are crucial for raising awareness of the harms of tobacco, thus preventing its uptake among adolescents. Studies conducted recently have recognized the need to bring change and reinforce ongoing school-based anti-tobacco education programs. Our study protocol aims to evaluate the effectiveness of a revised school-based anti-tobacco education on susceptibility to tobacco use among school-going adolescents.

Method: Project TEACH (Tobacco Education and Awareness for Creating Healthier Adolescents) is an educational intervention that will comprise an animated video on the effects of tobacco on physical and mental health, along with dispelling myths about tobacco, which will be delivered along with a standard education program. The control group will only receive the standard school-based anti-tobacco education program. It will be conducted among students between 6^th to 10^th grade, with a sample size of 3,310 students.

Results: Bivariate relations between the main socio-demographic characteristics and susceptibility to tobacco use will be tested using Pearson or Spearman's correlation coefficients. For multivariable analyses, the binary logistic regression analysis is used to establish a risk model to correlate the socio-demographic factors with susceptibility to tobacco use and awareness of the harms of tobacco.

Conclusion: Project TEACH aims to provide a sustainable school-based anti-tobacco education intervention. It will help test the effectiveness of the revised intervention, which could be incorporated into the current school education program being conducted in the district.

Randomized controlled trials (RCTs) are a gold standard in evidence-based research. However, RCTs have limitations, among which the most commonly acknowledged is that narrow study selection criteria compromise the external validity of the findings. This article briefly touches upon this and other well-recognized limitations and presents, in greater detail, less commonly acknowledged limitations with examples from contemporary literature. Important among the less commonly acknowledged limitations are biases in RCTs of interventions to which patients cannot be blinded, weaknesses in the design of maintenance therapy RCTs, and, ubiquitously, post-randomization biases. The listed limitations notwithstanding, RCTs are still the best among research designs. What is important is to recognize the imperfections in each RCT so that the findings of the RCT can be better judged.

Background: Inflammatory cytokines are associated with the pathophysiology of major depressive disorder (MDD). Nevertheless, whether they are trait or state biomarkers remains unclear. We aimed to assess and compare selected cytokines, miRNAs, and oxidative stress biomarker levels between patients with MDD, first-degree relatives (FDRs), and unrelated healthy controls (UHCs).

Methods: Using a cross-sectional design, we recruited patients with MDD, their FDRs and age, gender, body mass index-matched UHCs. Serum levels of IL-6, IL-1β, TNF-α, hs-CRP, and IL-10 were evaluated using the Enzyme-Linked Immunosorbent Assay (ELISA) method. We quantified the gene expressions of plasma miR-16, miR-132, and miR-1202 using Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). We estimated the total oxidant status and total antioxidant status levels in the serum by ELISA. We used sequential multiple linear regression analysis to find the association between MDD vs. UHCs (model 1), FDRs vs. UHCs (model 2), and MDD vs. FDRs (model 3) after adjusting for age, gender, and BMI as covariates.

Results: The study involved 50 patients with MDD (mean age = 34.7 ± 10.1 years), 31 FDRs (mean age = 32.7 ± 12.2 years), and 50 UHCs (mean age = 34.1 ± 10.3 years). Patients with MDD had higher levels IL-6 (β = 6.04; 95% CI; 1.60 to 10.49; p = 0.008) and downregulated miR-1202 (β = -0.38; 95% CI: -0.70 to -0.06; p = 0.02) compared to FDRs with statistically significant differences.

Conclusion: The higher levels of serum IL-6 and downregulated plasma miR-1202 expression in patients with MDD compared to FDRs may be a state biomarkers in MDD. However, an adequately powered study can answer these questions with certainty.

Background: Suicide attempts have become a major mental health concern, with increasing rates in recent years. There is a clear connection between suicide attempts and depression. Many studies suggest that people suffering from depression show increased platelet activity. However, the changes in mean platelet volume (MPV) in individuals with attempted suicide have not been well-studied in the Indian setup. Understanding the psychosocial and biological factors is crucial for effective prevention and intervention strategies. This study aims to explore the relationship between clinical and psychosocial factors and MPV in individuals with attempted suicide.

Methodology: This was a hospital-based, descriptive, observational, cross-sectional study. Data was collected from 150 consecutive referrals of suicide attempt cases to the psychiatry outpatient department from January 2021 to December 2021 after obtaining informed consent. Socio-demographic information was gathered using a semi-structured proforma. Clinical and psychological evaluations were conducted using the Beck Suicidal Intent Scale (BSI), Beck Depression Inventory (BDI), and the Presumptive Stressful Life Events Scale (PSLE). MPV values were obtained from complete blood count reports using the Beckman Coulter method.

Results: In this study, 150 individuals who attempted suicide were assessed, with a majority being male (70%). The most common method of attempt was pesticide consumption, accounting for 88.7% of cases. Depression was present in 27.3% of these cases. We found a significant positive correlation between the severity of depression (p < .001) and the level of suicidal intent (p < .05). Additionally, patients with depression had significantly higher MPV levels (p < .05) compared to those without depression.

Conclusion: Our findings highlight the link between suicide attempts and increased platelet activity, emphasizing the need for further research to understand the biological markers associated with suicide risk. This understanding could lead to better prevention and intervention strategies, ultimately helping to save lives.

Background: Mental health literacy among lay community health workers (CHWs) is crucial to ensuring that mental health services are accessible to all. This research explores the mental health literacy of community health workers in Indonesia.

Methods: A cross-sectional study was carried out among 454 female community health workers from various villages. Their understanding of mental illness was assessed through questionnaires, exploring their overall belief about the cause and consequence of mental illness, the symptom and the treatment of mental illness, and their perception of relapse.

Results: Most participants have false beliefs about the causes and consequences of mental illness. For instance, the majority of respondents agreed that severe stress leads to mental illness (80%), while 60.4% believed personal weakness to be a cause. Cognitive impairments and brain disease were associated with mental illness by 67.2% and 57.3%, respectively, although only 32.6% attributed it to hereditary factors. Regarding treatment, 83.9% of respondents believed that consistent medication could fully cure mental disorders, while 81.1% associated mental illness with strange behavior. Additionally, 90.7% of respondents emphasized the importance of regular medication to prevent relapse, with 81.5% stating that lack of medication leads to relapse.

Conclusion: A significant level of misinformation and misconception among participants regarding mental illness was unveiled. This misunderstanding can contribute to the stigmatization of individuals experiencing stress, as it may lead to unwarranted assumptions about their mental health. These findings underscore the importance of targeted mental health education campaigns to address misconceptions.

Purpose of the review: Psychotherapy remains a fundamental component of mental health treatment, yet it encounters significant barriers to accessibility and efficacy. The integration of digital therapies, encompassing e-Health, m-Health, and artificial intelligence (AI) offers the transformative potential to enhance therapeutic processes through automated systems that improve access and personalize treatment. This integration, however, involves complex considerations, including health-related quality of life (HRQoL) and the dynamics of the therapeutic alliance. This narrative review synthesizes current literature on the application of digital therapies in psychotherapy, with a focus on attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), schizophrenia, and substance use disorders (SUDs). The review evaluates the effectiveness of these interventions, their impact on HRQoL, therapeutic relationships, and the associated ethical considerations.

Collection and analysis of data: Following Green's checklist for narrative reviews, a systematic literature review was conducted on studies published from January 2009 to May 2024. Inclusion criteria centered on digital therapies, including AI-based, Internet-based, and mobile-based interventions in psychotherapy. A total of 23 studies were analyzed.

Conclusions: The findings indicate that digital therapies hold substantial promise for enhancing therapeutic interventions across various mental health disorders, particularly through chatbots and Internet-based psychotherapy. However, successful integration requires careful attention to the therapeutic alliance, HRQoL, and ethical implications. This review highlights the significant potential of digital therapies, including AI-driven psychotherapy, in managing diverse mental health disorders. A balanced approach to integration, prioritizing patient well-being and addressing ethical complexities, is essential for optimizing treatment outcomes.