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Kashyap R, Holla B, Bhattacharjee S, Sharma E, Mehta UM, Vaidya N, Bharath RD, Murthy P, Basu D, Nanjayya SB, Singh RL, Lourembam R, Chakrabarti A, Kartik K, Kalyanram K, Kumaran K, Krishnaveni G, Krishna M, Kuriyan R, Kurpad SS, Desrivieres S, Purushottam M, Barker G, Orfanos DP, Hickman M, Heron J, Toledano M, Schumann G, Benegal V. Childhood adversities characterize the heterogeneity in the brain pattern of individuals during neurodevelopment. Psychol Med 2024:1-13. [PMID: 38509831 DOI: 10.1017/s0033291724000710] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
BACKGROUND Several factors shape the neurodevelopmental trajectory. A key area of focus in neurodevelopmental research is to estimate the factors that have maximal influence on the brain and can tip the balance from typical to atypical development. METHODS Utilizing a dissimilarity maximization algorithm on the dynamic mode decomposition (DMD) of the resting state functional MRI data, we classified subjects from the cVEDA neurodevelopmental cohort (n = 987, aged 6-23 years) into homogeneously patterned DMD (representing typical development in 809 subjects) and heterogeneously patterned DMD (indicative of atypical development in 178 subjects). RESULTS Significant DMD differences were primarily identified in the default mode network (DMN) regions across these groups (p < 0.05, Bonferroni corrected). While the groups were comparable in cognitive performance, the atypical group had more frequent exposure to adversities and faced higher abuses (p < 0.05, Bonferroni corrected). Upon evaluating brain-behavior correlations, we found that correlation patterns between adversity and DMN dynamic modes exhibited age-dependent variations for atypical subjects, hinting at differential utilization of the DMN due to chronic adversities. CONCLUSION Adversities (particularly abuse) maximally influence the DMN during neurodevelopment and lead to the failure in the development of a coherent DMN system. While DMN's integrity is preserved in typical development, the age-dependent variability in atypically developing individuals is contrasting. The flexibility of DMN might be a compensatory mechanism to protect an individual in an abusive environment. However, such adaptability might deprive the neural system of the faculties of normal functioning and may incur long-term effects on the psyche.
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Affiliation(s)
- Rajan Kashyap
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Bharath Holla
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Sagarika Bhattacharjee
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Eesha Sharma
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Nilakshi Vaidya
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, PONS Centre, Charité Mental Health, Germany
- Department of Psychiatry, Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Debashish Basu
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Roshan Lourembam
- Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, India
| | - Amit Chakrabarti
- Division of Mental Health, ICMR-Centre for Ageing and Mental Health, Kolkata, India
| | - Kamakshi Kartik
- Rishi Valley Rural Health Centre, Madanapalle, Chittoor, India
| | | | - Kalyanaraman Kumaran
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
- MRC Lifecourse Epidemiology Unit, University of Southampton, UK
| | - Ghattu Krishnaveni
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - Murali Krishna
- Health Equity Cluster, Institute of Public Health, Bangalore, India
| | - Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, Bengaluru, India
| | - Sunita Simon Kurpad
- Department of Psychiatry & Department of Medical Ethics, St John's Research Institute, Bengaluru, India
| | - Sylvane Desrivieres
- SGDP Centre, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Meera Purushottam
- Molecular Genetics Laboratory, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Gareth Barker
- Department of Neuroimaging, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | | | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jon Heron
- Center for Public Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mireille Toledano
- MRC Centre for Environment and Health, School of Public Health, Imperial College, London, UK
| | - Gunter Schumann
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, PONS Centre, Charité Mental Health, Germany
- PONS Centre, Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Nadkarni A, Gaikwad L, Sequeira M, D'souza J, Lopes M, Haldankar R, Murthy P, Velleman R, Bhatia U, Naughton F. Text message-based Cessation Intervention for People who Smoked or Used Smokeless Tobacco in India: a Feasibility Randomised Controlled Trial. Nicotine Tob Res 2024:ntae056. [PMID: 38468498 DOI: 10.1093/ntr/ntae056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Despite the high burden of tobacco use in India, users do not have access to adequate help. This pilot trial aimed to evaluate the feasibility and acceptability of a text messaging intervention for tobacco cessation, generate preliminary estimates of its impact, and fine-tune procedures for a definitive trial. METHODS Parallel two-arm single blind individually randomised controlled pilot trial with nested qualitative study. Participants included adult current tobacco users (smoked and smokeless). Eligible and consenting participants were randomised to receive either (a) text messaging intervention (ToQuit) which covered specific content areas such as psychoeducation about consequences of tobacco use and benefits of quitting and tobacco avoidance strategies or (b) information about tobacco cessation helplines such as the helpline number and the languages in which tobacco cessation support was available (control). Feasibility data included screening and consent rates, treatment dropouts and outcome ascertainment. The primary abstinence outcome was self-reported abstinence from tobacco in the past seven days at three months post-randomisation. In-depth interviews were conducted with a sub-sample of participants primarily to collect acceptability data. The primary abstinence analysis used a chi-squared test and logistic regression (complete-case), and qualitative data analysed using thematic analysis. RESULTS Ninety eight participants were randomised into the two trial arms; 77 (79%) completed outcome evaluation. No between-arm differences in abstinence were found though findings favoured the intervention (7-day abstinence: ToQuit 23%, control 19%; adjusted odds ratio 1.23, 95% confidence interval 0.38, 3.97). Participants appreciated the language, comprehensibility, and relevance of the messages; and reported overall satisfaction with and positive impact from the intervention on their lives. CONCLUSION The findings indicate the acceptability and feasibility of ToQuit and if found effective, it could be a potentially scalable first-line response to tobacco use in low resource settings. IMPLICATIONS Our pilot RCT provides sufficient findings supporting the acceptability and feasibility of an intervention for tobacco cessation which is suitable for a context which has a shortage of healthcare workers and for individuals who use smoked or smokeless tobacco. This is critical on a background of limited contextually relevant interventions for a problem with a high burden in low- and middle- income countries such as India.
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Affiliation(s)
- Abhijit Nadkarni
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Addictions and Related Research Group, Sangath, Goa, India
| | - Leena Gaikwad
- Addictions and Related Research Group, Sangath, Goa, India
| | | | | | - Megan Lopes
- Addictions and Related Research Group, Sangath, Goa, India
| | | | - Pratima Murthy
- National Institute of Mental Health & Neurosciences, Bengaluru, India
| | - Richard Velleman
- Addictions and Related Research Group, Sangath, Goa, India
- Department of Psychology, University of Bath, Bath, UK
| | - Urvita Bhatia
- Addictions and Related Research Group, Sangath, Goa, India
- Department of Psychology, Health & Professional Development, Oxford Brookes University, Oxford, UK
| | - Felix Naughton
- School of Health Sciences, University of East Anglia, UK
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Nadkarni A, Gaikwad L, Sequeira M, Velleman R, D'souza J, Hoble A, Haldankar R, Murthy P, Naughton F. Evaluation of Feasibility and Acceptability of a Text-Messaging Intervention for Tobacco Cessation in India. Nicotine Tob Res 2024; 26:72-78. [PMID: 37638548 PMCID: PMC10734385 DOI: 10.1093/ntr/ntad163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/26/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023]
Abstract
INTRODUCTION The aim of our study was to assess the feasibility and acceptability of a brief behavioral intervention for tobacco cessation delivered via mobile phone text messaging in India. AIMS AND METHODS We conducted an uncontrolled intervention cohort study in adult current users of tobacco. The participants received intervention messages on their mobile phones for eight weeks. We collected qualitative data about participants' perceptions of intervention delivery and receipt, acceptability, and feasibility of the intervention. The outcomes measured at 3 months post-recruitment were self-reported 7- and 28-day point-prevalence abstinence, and Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) risk categories for tobacco-low (0-3), moderate (4-26), and high (≥27). RESULTS We recruited 26 eligible participants, and 22 completed the outcome assessments. The participants generally perceived the intervention content to be simple to access and useful in facilitating a change in tobacco use. None of the participants indicated that they wanted to discontinue receiving the intervention messages. Some suggestions for enhancing acceptability included supplementing text messaging with more intensive counseling and the use of multimedia content. Eighteen percent of participants reported abstinence in the past 7 and 28 days. A greater proportion of those who used smokeless tobacco were abstinent at follow-up compared to those who smoked (42.9% vs. 6.7%; p = .04). CONCLUSIONS If effective, simple and low-cost mobile phone text messaging can be used to deliver interventions for tobacco use, and has the potential to be scaled up so it can be delivered to populations of smokers interested in receiving cessation support. IMPLICATIONS Our study is an important step towards the development of a contextually relevant intervention suited for low- and middle-income countries and which is responsive to the needs of both those who use smoked and smokeless tobacco. If found to be effective, our intervention would be a scalable solution to overcome the human resource related barrier to accessing tobacco cessation services in low resource settings.
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Affiliation(s)
- Abhijit Nadkarni
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Addictions and Related Research Group (ARG), Sangath, India
| | - Leena Gaikwad
- Addictions and Related Research Group (ARG), Sangath, India
| | | | - Richard Velleman
- Addictions and Related Research Group (ARG), Sangath, India
- Department of Psychology, University of Bath, Bath, UK
| | | | - Ankita Hoble
- Addictions and Related Research Group (ARG), Sangath, India
| | | | - Pratima Murthy
- National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Felix Naughton
- School of Health Sciences, University of East Anglia, Norwich, UK
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Rajan S, Mitchell A, Zavala GA, Podmore D, Khali H, Chowdhury AH, Muliyala KP, Appuhamy KK, Aslam F, Nizami AT, Huque R, Shiers D, Murthy P, Siddiqi N, Siddiqi K. Tobacco use in people with severe mental illness: Findings from a multi-country survey of mental health institutions in South Asia. Tob Induc Dis 2023; 21:166. [PMID: 38098747 PMCID: PMC10720264 DOI: 10.18332/tid/174361] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION People with severe mental illness (SMI) tend to die early due to cardiovascular and respiratory diseases, which may be linked to tobacco use. There is limited information on tobacco use in people with SMI in low- and middle-income countries where most tobacco users reside. We present novel data on tobacco use in people with SMI and their access to tobacco cessation advice in South Asia. METHODS We conducted a multi-country survey of adults with SMI attending mental health facilities in Bangladesh, India, and Pakistan. Using data collected with a standardized WHO STEPS survey tool, we estimated the prevalence and distribution of tobacco use and assessed receipt of tobacco cessation advice. RESULTS We recruited 3874 participants with SMI; 46.8% and 15.0% of men and women consumed tobacco, respectively. Smoking prevalence in men varied by country (Bangladesh 42.8%, India 20.1% and Pakistan 31.7%); <4% of women reported smoking in each country. Smokeless tobacco use in men also varied by country (Bangladesh 16.2%, India 18.2% and Pakistan 40.8%); for women, it was higher in Bangladesh (19.1%), but similar in India (9.9%) and Pakistan (9.1%). Just over a third of tobacco users (38.4%) had received advice to quit tobacco. Among smokers, 29.1% (n=244) made at least one quit attempt in the past year. There was strong evidence for the association between tobacco use and the severity of depression (OR=1.29; 95% CI: 1.12-1.48) and anxiety (OR=1.29; 95% CI: 1.12-1.49). CONCLUSIONS As observed in high-income countries, we found higher tobacco use in people with SMI, particularly in men compared with rates reported for the general population in South Asia. Tobacco cessation support within mental health services offers an opportunity to close the gap in life expectancy between SMI and the general population. STUDY REGISTRATION ISRCTN88485933; https://doi.org/10.1186/ISRCTN88485933 39.
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Affiliation(s)
- Sukanya Rajan
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Alex Mitchell
- Department of Health Sciences, University of York, York, United Kingdom
| | - Gerardo A. Zavala
- Department of Health Sciences, University of York, York, United Kingdom
| | - Danielle Podmore
- Department of Health Sciences, University of York, York, United Kingdom
| | | | | | | | | | - Faiza Aslam
- Institute of Psychiatry, Rawalpindi, Pakistan
| | | | | | - David Shiers
- Psychosis Research Unit, Greater Manchester Mental Health National Health Service Foundation Trust, Manchester City, United Kingdom
- Division of Psychology and Mental Health, The University of Manchester, Manchester City, United Kingdom
- School of Medicine, Keele University, Keele, United Kingdom
| | - Pratima Murthy
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Najma Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom
- Bradford District Care National Health Service Foundation Trust, Bradford, United Kingdom
- Hull York Medical School, Hull, United Kingdom
- Hull York Medical School, York, United Kingdom
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, Hull, United Kingdom
- Hull York Medical School, York, United Kingdom
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Shankarappa B, Mahadevan J, Murthy P, Purushottam M, Viswanath B, Jain S, Devarbhavi H, Mysore V A. A study of genetic variants, genetic risk score and DNA methylation of PNPLA3 and TM6SF2 in alcohol liver cirrhosis. Indian J Gastroenterol 2023; 42:800-807. [PMID: 37589914 DOI: 10.1007/s12664-023-01420-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/20/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Genetic and epigenetic factors are associated with the development of alcohol-associated liver disease (AALD). The single nucleotide polymorphisms (SNPs), rs738409 in Patatin-like phospholipase domain-containing protein (PNPLA3) and rs58542926 in Transmembrane 6 Superfamily Member 2 (TM6SF2) are strongly associated with AALD in different global populations, Hence, we analyzed the genetic risk score for these variants and deoxyribonucleic acid (DNA) methylation levels of the PNPLA3 and TM6SF2 genes among cases (alcohol liver cirrhosis) and controls (heavy drinkers without cirrhosis). METHOD We studied patients with alcohol use disorder (AUD) with cirrhosis (AUD-C + ve, n = 136) and without cirrhosis (AUD-C-ve, n = 107) drawn from the clinical services of St. John's Medical College Hospital (SJMCH) (Gastroenterology and Psychiatry) and Centre for Addiction Medicine (CAM), National Institute of Mental Health and Neurosciences, (NIMHANS). Genotype data was generated for rs738409 (PNPLA3) and rs58542926 (TM6SF2) and used to calculate unweighted genetic risk score (uGRS) and weighted genetic risk scores (wGRS). DNA methylation levels were estimated by pyrosequencing at PNPLA3 and TM6SF2 loci. RESULTS Overall we observed a significantly higher genetic risk score (weighted genetic risk score, wGRS) in individuals with alcohol use disorder compared to control population (p = < 0.01). Further, uGRS and wGRS were associated with the diagnosis of cirrhosis, even after correcting for age of onset, quantity and frequency of drinking. We also found hypomethylation at CpG2 of TM6SF2 gene in AUD-C + ve compared to AUD-C-ve (P = 0.02). CONCLUSION We found that a genetic risk score based on SNPs in the PNPLA3 and TM6SF2 genes was significantly associated with cirrhosis in patients with AUD, suggesting a potential utility in identifying patients at risk and providing pre-emptive interventions. These may include interventions that aim to alter DNA methylation, which may be one of the mechanisms through which elevated genetic risk may influence the development of cirrhosis.
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Affiliation(s)
- Bhagyalakshmi Shankarappa
- Department of Psychiatry, St John's Medical College Hospital, Bengaluru 560 034, India
- Molecular Genetics Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, 560 030, India
| | - Jayant Mahadevan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, 560 030, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, 560 030, India
| | - Meera Purushottam
- Molecular Genetics Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, 560 030, India.
| | - Biju Viswanath
- Molecular Genetics Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, 560 030, India
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, 560 030, India
| | - Sanjeev Jain
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, 560 030, India
| | - Harshad Devarbhavi
- Department of Gastroenterology, St John's Medical College Hospital, Bengaluru, 560 034, India
| | - Ashok Mysore V
- Department of Psychiatry, St John's Medical College Hospital, Bengaluru 560 034, India
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Zainab R, Kandasamy A, Bhat NA, Dsouza CV, Jennings H, Jackson C, Mazumdar P, Hewitt CE, Ekers D, Narayanan G, Rao GN, Coales K, Muliyala KP, Chaturvedi SK, Murthy P, Siddiqi N. Behavioral Activation for Comorbid Depression in People With Noncommunicable Disease in India: Protocol for a Randomized Controlled Feasibility Trial. JMIR Res Protoc 2023; 12:e41127. [PMID: 37971791 PMCID: PMC10690525 DOI: 10.2196/41127] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 03/23/2023] [Accepted: 04/18/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The increasing burden of depression and noncommunicable disease (NCD) is a global challenge, especially in low- and middle-income countries, considering the resource constraints and lack of trained human resources in these settings. Effective treatment of depression in people with NCDs has the potential to enhance both the mental and physical well-being of this population. It will also result in the effective use of the available health care resources. Brief psychological therapies, such as behavioral activation (BA), are effective for the treatment of depression. BA has not been adapted in the community health care services of India, and the feasibility of using BA as an intervention for depression in NCD and its effectiveness in these settings have not been systematically evaluated. OBJECTIVE Our objective is to adapt BA for the Indian NCD context and test the acceptability, feasibility, and implementation of the adapted BA intervention (BEACON intervention package [BIP]). Additionally, we aim to test the feasibility of a randomized controlled trial evaluation of BIP for the treatment of depression compared with enhanced usual care. METHODS Following well-established frameworks for intervention adaptation, we first adapted BA (to fit the linguistic, cultural, and resource context) for delivery in India. The intervention was also adapted for potential remote delivery by telephone. In a randomized controlled trial, we will be testing the acceptability, feasibility, and implementation of the adapted BA intervention (BIP). We shall also test if a randomized controlled feasibility trial can be delivered effectively and estimate important parameters (eg, recruitment and retention rates and completeness of follow-up) needed to design a future definitive trial. RESULTS Following the receipt of approval from all the relevant agencies, the development of the BIP was started on November 28, 2020, and completed on August 18, 2021, and the quantitative data collection was started on August 23, 2021, and completed on December 10, 2021. Process evaluation (qualitative data) collection is ongoing. Both the qualitative and quantitative data analyses are ongoing. CONCLUSIONS This study may offer insights that could help in closing the gap in the treatment of common mental illness, particularly in nations with limited resources, infrastructure, and systems such as India. To close this gap, BEACON tries to provide BA for depression in NCDs through qualified NCD (BA) counselors integrated within the state-run NCD clinics. The results of this study may aid in understanding whether BA as an intervention is acceptable for the population and how feasible it will be to deliver such interventions for depression in NCD in South Asian countries such as India. The BIP may also be used in the future by Indian community clinics as a brief intervention program. TRIAL REGISTRATION Clinical Trials Registry of India CTRI/2020/05/025048; https://tinyurl.com/mpt33jv5. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41127.
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Affiliation(s)
- Rayeesa Zainab
- National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Arun Kandasamy
- National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Naseer Ahmad Bhat
- Jindal School of Psychology and Counselling, O P Jindal Global University, Sonipat, India
| | | | - Hannah Jennings
- Department of Health Sciences, University of York & Hull York Medical School, Heslington, United Kingdom
| | - Cath Jackson
- Valid Research LTD, West Yorkshire, United Kingdom
| | - Papiya Mazumdar
- School of Politics and International Studies, Faculty of Social Science, University of Leeds, Leeds, United Kingdom
| | | | - David Ekers
- Tees Esk and Wear Valleys NHS Foundation Trust, North Yorkshire, United Kingdom
- Department of Medicine, Pharmacy, and Health, Durham University, North Yorkshire, United Kingdom
| | | | - Girish N Rao
- National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Karen Coales
- Department of Health Sciences, University of York & Hull York Medical School, Heslington, United Kingdom
| | | | | | - Pratima Murthy
- National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Najma Siddiqi
- Department of Health Sciences, University of York & Hull York Medical School, Heslington, United Kingdom
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Shivaprakash P, Patel V, Shadakshari D, Verma R, Shukla L, Mahadevan J, Kandasamy A, Chand PK, Benegal V, Sethuraman L, Sharma P, Murthy P. A descriptive study of hepatitis C in people who inject drugs. Indian J Med Res 2023; 158:559-564. [PMID: 38084934 PMCID: PMC10878480 DOI: 10.4103/ijmr.ijmr_2634_22] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND OBJECTIVES The seroprevalence of the hepatitis C virus (HCV) in general population is higher than that of human immunodeficiency virus (HIV) in India. People who inject drugs (PWIDs) constitute a high-risk group for all blood-borne infections. Multiple behavioural surveillance surveys have provided a rich typology of HIV-infected PWIDs, but this information is missing for HCV infection. We describe awareness, transmission risk factors and the treatment continuum for HCV infection among PWID. We also report spatial clustering of HCV infection in PWIDs residing in Bengaluru. METHODS Information from clinical records was collected and telephonic interviews of retrospectively identified PWIDs who received treatment at a tertiary-level addiction treatment facility between 2016 and 2021 were conducted. RESULTS We identified 391 PWIDs; 220 (56.26%) received an anti-HCV antibody test (4 th Generation HCV-Tridot). Individuals reporting unsafe injection practices were more often tested than those who did not ( χ2 =44.9, df=1, P <0.01). Almost half of the tested and more than a quarter of the whole sample (109/220, 49.9%; 109/391, 27.9%) were seropositive for HCV infection. The projected seropositivity in this group was between 27.9 per cent (best case scenario, all untested assumed negative) and 71.6 per cent (worst case scenario, all untested assumed positive). Only a minority of participants interviewed were aware of HCV (27/183, 14.7%). HCV infection and its associated risk behaviour (PWID) were clustered in certain localities (Diggle and Chetwynd Test; P =0.001) in Bengaluru in the southern district of Karnataka. INTERPRETATION CONCLUSIONS Undetected HCV infection is common in PWIDs; awareness and treatment uptake is poor in this group. Spatial clustering of infections in a district shows transmission in close networks and provides opportunities for targeted interventions.
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Affiliation(s)
- Prakrithi Shivaprakash
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vinit Patel
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Darshan Shadakshari
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Rahul Verma
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Lekhansh Shukla
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Jayant Mahadevan
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Arun Kandasamy
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Prabhat Kumar Chand
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vivek Benegal
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Lakshmanan Sethuraman
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Priyamvada Sharma
- Department of Clinical Psychopharmacology & Neurotoxicology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Meena P, Narayanan G, Murthy P. Rare case of chronic naphthalene ball ingestion in a young Indian woman. J Family Med Prim Care 2023; 12:2973-2975. [PMID: 38186784 PMCID: PMC10771217 DOI: 10.4103/jfmpc.jfmpc_352_23] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 01/09/2024] Open
Abstract
Chronic oral abuse of naphthalene balls is extremely rare. It is associated with different types of metabolic toxicity, neurological deficits and multiple organ failure. However, the psychological implication of naphthalene abuse is poorly understood. This is a unique case report of a 29-year-old lady who presented with a 17 year history of naphthalene ball consumption. Historically, there have been self-harm behaviors, fire setting, cleaning compulsions, and involuntary motor movements associated with naphthalene. A series of assessments were conducted to assess her personality, psychiatric symptoms and cognitive functions. Additionally, blood tests, CT scan and MRI were done. The patient's profile indicated no apparent medical, neurological or cognitive impairments. Her psychological profile revealed significant co-morbidities and marked personality pathology. The case study provides useful insights into the presentation of chronic naphthalene ball ingestion in an Indian woman, thereby indicating the need to identify psychosocial and biological markers longitudinally. It also highlights recognition of common household items that can be abused, suggesting better understanding of protecting vulnerable individuals from the same.
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Affiliation(s)
- Pratibha Meena
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Gitanjali Narayanan
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Sharma P, Rao V, Chand PK, Murthy P. Quantification of Δ9-tetrahydrocannabinol in urine as a marker of cannabis abuse. Indian J Med Res 2023; 158:535-541. [PMID: 37929356 PMCID: PMC10878489 DOI: 10.4103/ijmr.ijmr_3899_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND OBJECTIVES Cannabis use has long been associated with celebration and hospitality, although abuse must be confirmed through testing. It has always been difficult to develop an accurate and reliable confirmatory method for the quantification of tetrahydrocannabinol carboxylic acid (THC-COOH) that meets local requirements. The goal was to develop a rapid, cost-effective analytical technique that can handle large batches. METHODS Because of the wide metabolite detection window and ease of collection, urine was preferable sample. The extraction of a pre-screened urine sample (adulteration and multidrug screening) was done on Bond Elut cartridges using a positive pressure vacuum manifold, followed by quantification using a gas chromatograph and mass spectrometer. RESULTS The assay was linear between 15 and 300 ng/ml ( r2 of 0.99). The intra-day precision was 8.69 per cent and the inter-day precision was 10.78 per cent, respectively with a 97.5 per cent recovery rate for the lowest concentration. A total of 939 urine samples were examined, with 213 detecting cannabis. Sixty per cent of the total individuals tested positive for simply cannabinoids, 33 per cent for cannabinoids and sedatives, five per cent for cannabinoids and morphine and one for cannabis, morphine and cocaine. INTERPRETATION CONCLUSIONS Assay characteristics included modest sample preparation, rapid chromatography, high specificity and small sample volume with a processing time of 12 h. The assay described here can be applied for diagnostic laboratories and in forensic settings as well.
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Affiliation(s)
- Priyamvada Sharma
- Department of Clinical Psychopharmacology & Neurotoxicology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Vijayashree Rao
- Department of Centre for Addicition Medicine, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Prabhat Kumar Chand
- Department of Centre for Addicition Medicine, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Department of Clinical Psychopharmacology & Neurotoxicology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
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Radhika P, Basavarajappa C, Dahale AB, Arumugham SS, Jaisoorya TS, Jain S, Murthy P. Exploring the early history of convulsive therapies at the Mysore Government Mental Hospital (currently NIMHANS). Asian J Psychiatr 2023; 89:103747. [PMID: 37647785 DOI: 10.1016/j.ajp.2023.103747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/26/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE The paper describes the introduction, and early use of chemically and electrically induced convulsive therapies, at the Mysore Government Mental Hospital (MGMH), now the National Institute of Mental Health and Neuro Sciences, Bangalore, India. Cardiazol and ammonium chloride were used at MGMH before the introduction of electroconvulsive therapy (ECT). The study examines the early history, clinical correlates and outcome of convulsive therapies and attempts to contextualize how local conditions influenced implementation. METHOD Three sets of archival case-records from 1938 to 1948, each of a period of 9 months following the implementation of a particular mode of convulsive therapy were reviewed. RESULTS During the examined timeframe, 40 patients received cardiazol, 95 ammonium chloride and 50 unmodified ECT. Schizophrenia was the commonest clinical indication for convulsive therapy across all modalities of treatment. When outcomes were examined, 45%, 48.4% and 62% of patients were clinically reported to have been either cured/improved after receiving cardiazol, ammonium chloride and ECT respectively. Those receiving cardiazol had a high mortality of 22.5%, compared to 3.1% for ammonium chloride and 4% with ECT. CONCLUSIONS Convulsive therapies were one of the first somatic psychiatric treatments, introduced around 1930s and 1940s all over the world, including in India. Our archival records suggest that many international ideas about somatic treatments were quickly adopted in India. Electroconvulsive therapy and other novel neuromodulatory interventions continue to be used and actively researched in India.
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Affiliation(s)
- P Radhika
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Chethan Basavarajappa
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Ajit Bhalchandra Dahale
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Shyam Sundar Arumugham
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - T S Jaisoorya
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Sanjeev Jain
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India.
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Fiorillo A, Javed A, Azeem MW, Basu D, Lam LCW, Murthy P, Ndetei D, Okasha T, Stein DJ, Bhui KS. Education, policy and clinical care in mental health: an update on the activities of WPA Collaborating Centres. World Psychiatry 2023; 22:495-496. [PMID: 37713543 PMCID: PMC10503928 DOI: 10.1002/wps.21144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 09/17/2023] Open
Affiliation(s)
- Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | | | | | - Debasish Basu
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Linda C W Lam
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - David Ndetei
- Department of Psychiatry, University of Nairobi and Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Dan J Stein
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Kamaldeep S Bhui
- Department of Psychiatry and Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Ellsworth SG, Ross A, Shiue K, Murthy P, Patel RB, Zellars RC, Miller AC, Russ KA, Lotze M. Influence of Radiation Fractionation on Immune Repertoire Diversity in Solid Tumor Patients. Int J Radiat Oncol Biol Phys 2023; 117:S157. [PMID: 37784394 DOI: 10.1016/j.ijrobp.2023.06.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation (RT)-induced lymphopenia (RIL) occurs in up to 75% of patients undergoing RT and is associated with worse tumor control and survival across a spectrum of solid tumors. Patients undergoing hypofractionated RT are at lower risk of RIL compared with patients treated with more prolonged RT courses. However, it is unknown whether immune repertoire diversity is similarly affected by fractionation scheme in patients undergoing RT. This prospective study analyzed RT-induced changes in immune repertoire diversity in patients treated with conventionally (CFRT) vs hypofractionated RT (HFRT). MATERIALS/METHODS RNA-based T and B cell receptor sequencing was performed on peripheral lymphocytes collected prospectively before RT and within 4 weeks of the last RT fraction from 23 patients (18 men, 5 women, median age 67 y) with primary solid tumors undergoing CFRT (≤3 Gy/day x ≥10 days, n = 13) or HFRT (≥5 Gy/day x ≤5 days, n = 10). Absolute lymphocyte counts (ALC; cells/μL) were obtained from clinical laboratory data. The number of unique CDR3 receptors (uCDR3) and Shannon entropy were used to monitor changes in T (TCR Vβ) and B (BCR IgH) receptor diversity. RESULTS ALC decreased after RT in 90% (20/22) of patients (mean pre-RT ALC 1830 vs 1040 post-RT, p <0.001). Mean % ALC loss was greater in CFRT vs HFRT patients (44.3 vs. 35.2%). After RT, entropy in IgH and Vβ decreased in 18/23 (78%) and 17/23 (74%) patients, respectively; uCDR3 in IgH and Vβ decreased in 14/23 (61%) and 15/23 (65%). Among patients with concordant decreases in ALC and uCDR3, a moderate correlation between magnitude of ALC loss and uCDR3 levels in the T-cell receptor Vβ was observed (r = 0.64, p = 0.02). For both receptor species studied (IgH and Vβ), HFRT patients were more likely to have an increase in either entropy or uCDR3 in the face of decreased ALC (36 vs 15%, X2 p = 0.03). Furthermore, while decreases in entropy were observed among the CFRT patients for both IgH (median entropy 10.4 vs 9.4, p = 0.06) and Vβ (9.7 vs 8.1, p = 0.02), entropy did not significantly change following RT in the HFRT patients (IgH 10.6 vs 10.4, p = 0.74 and Vβ 10.9 vs 10.8, p = 0.24). CONCLUSION RT-induced changes in immune repertoire diversity are variably reflected in the peripheral ALC. Both HFRT and CFRT depleted circulating lymphocytes, but patients undergoing HFRT were more likely to experience increases in T and B cell diversity metrics despite lymphopenia. It is therefore possible that relative sparing of repertoire diversity among patients undergoing HFRT could increase the likelihood of tumor antigen recognition by peripheral blood lymphocytes. As immune repertoire diversity is associated with the likelihood of response to immunotherapy, these findings also have implications for RT-immunotherapy combinations. Further study is required to understand the relationship between RT exposure to circulating lymphocyte populations and immune repertoire diversity.
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Affiliation(s)
- S G Ellsworth
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - A Ross
- University of Pittsburgh, Pittsburgh, PA
| | - K Shiue
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN
| | - P Murthy
- University of Pittsburgh Hillman Cancer Center, Pittsburgh, PA
| | - R B Patel
- UPMC Hillman Cancer Center, Pittsburgh, PA
| | - R C Zellars
- Indiana University Department of Radiation Oncology, Indianapolis, IN
| | | | - K A Russ
- Indiana University School of Medicine, Indianapolis, IN
| | - M Lotze
- University of Pittsburgh Hillman Cancer Center, Pittsburgh, PA
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Kumar PCP, Antony S, Murthy P, Thirumoorthy A, Philip M. Relationship of personality, psychological distress, and substance use with social network characteristics of college going young adults. Indian J Psychiatry 2023; 65:832-838. [PMID: 37736229 PMCID: PMC10510637 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_182_23] [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] [Received: 03/16/2023] [Revised: 06/28/2023] [Accepted: 07/12/2023] [Indexed: 09/23/2023] Open
Abstract
Background Causes of substance use are multifactorial. Factors such as personality, psychological distress, and the person's social ties contribute to the understanding of substance use problems of college students. Aim The current study aimed to investigate the association between personality traits and psychological distress with ego-centric social networks of substance-using and non-using college students. Method This cross-sectional descriptive study involved 902 undergraduate students from the government (n = 2) and government-aided (n = 9) colleges. The socio-demographic data sheet, Big Five Personality Inventory, Depression Anxiety and Stress Scale, and the semi-structured Ego-centric Social Network Questionnaire were used to collect data. Results Of 902 participants, 26.9% of participants used substances. The mean score of anxiety (P < 0.002) and depression (P < 0.002) was significantly higher among the substance users compared with non-users. Agreeableness (P < 0.001) and conscientiousness (P < 0.001) scores were significantly higher among non-users. Depression (P < 0.01), anxiety (P < 0.01), and stress (P < 0.01) correlated positively with the total number of substance users in the network. Agreeableness (P < 0.01) and conscientiousness (P < 0.01) were positively correlated with parents and siblings in the network. Stress emerged as a predictor (OR 1.61, CI 1.09-3.04, P < 0.001) for considering substance users to the social network. Conclusion Personality and psychological distress are associated with an individual's social network and significantly contribute to student substance use problems.
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Affiliation(s)
- P C Pradeep Kumar
- Department of Psychiatry, JSS Academy of Higher Education and Research, JSS Medical College Hospital, Mysore, Karnataka, India
| | - Sojan Antony
- Department of Psychiatric Social Work, NIMHANS, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry and Centre for Addiction Medicine, NIMHANS, Bengaluru, Karnataka, India
| | | | - Mariamma Philip
- Department of Biostatistics, NIMHANS, Bengaluru, Karnataka, India
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14
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Vajawat B, Kumar CN, Hegde P, Moirangthem S, Basavaraju V, Prathyusha V, Bhaskarapillai B, Math SB, Murthy P. Clinical Profile, Course and Outcomes of Male Inpatients with Mental Illness Charged with Homicide: A Chart Review from an Indian Tertiary Care Hospital. Indian J Psychol Med 2023; 45:405-410. [PMID: 37483583 PMCID: PMC10357911 DOI: 10.1177/02537176221127141] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Background The relationship between imprisonment and mental illness is bidirectional. The clinical outcomes of prisoners with mental illness have not been widely studied, especially in developing countries. This study was conducted to assess the same among male inpatients under judicial custody with charges of homicide. Methods A retrospective chart review of male forensic ward inpatients admitted between January 1, 2003, and December 31, 2016, was conducted. Diagnosis in the files was based on the International Classification of Diseases (ICD)-10 criteria. The Clinical and Global Improvement-Severity (CGI-S) scale was used to measure the severity of illness. Mean CGI-S assessment was carried out at baseline, end of 1 year, 5 years, and 15 years. The data were analyzed using descriptive statistics, Friedman's test, and Dunn's post hoc test. Results Schizophrenia spectrum disorders and other psychotic disorders, mood disorders, and alcohol use disorders were diagnosed in 62(49.6%), 22(17.6%), and 44(35.2%) subjects, respectively. Forty-one (32.8%) subjects had at least one readmission. The average CGI-S score for the total subjects was 5 (markedly ill) at baseline and 2 (borderline ill) at the end of their latest contact with the tertiary care hospital. For the 34 subjects (27.2%) who had follow-up information of 15 years, the average CGI-S score was 1 (normal, not at all ill) at the end of 15 years (P < 0.001). Conclusion Clinical outcomes of prisoners with mental illness seem promising, subject to the seamless availability of services. Studies from other parts of the country are required for a more systematic understanding of the requirements of care.
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Affiliation(s)
- Bhavika Vajawat
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Prakyath Hegde
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sydney Moirangthem
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vinay Basavaraju
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vasuki Prathyusha
- Dept. of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Binukumar Bhaskarapillai
- Dept. of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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15
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Chopra R, Murthy P, Narayanan G. Early maladaptive schemas in substance use disorders in the Indian context: Theoretical and therapeutic implications. Ind Psychiatry J 2023; 32:452-455. [PMID: 38161451 PMCID: PMC10756602 DOI: 10.4103/ipj.ipj_162_22] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 03/01/2023] [Accepted: 03/21/2023] [Indexed: 01/03/2024] Open
Abstract
Schema theory seems to be a relevant perspective in the overall understanding of substance use disorders (SUDs). Early maladaptive schemas (EMSs) are defined as self-defeating emotional and cognitive patterns that begin early in our development, repeat throughout life, and act as risk factors for mental health problems and substance use (SU). SU behavior acts as a means by which users attempt to avoid triggering the unpleasant and negative emotions inherent in their elevated schema. Thus, SU is often seen as a coping mechanism in schema theory. This has important implications in terms of assessment, treatment, and planning of interventions. Schema therapy would be a valuable addition to the current therapy practice, which emphasizes a dual focus on both SU and EMSs and uses an integrated framework of cognitive, behavioral, and experiential techniques to target and modify EMSs.
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Affiliation(s)
- Ratnesh Chopra
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Gitanjali Narayanan
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
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Shankarappa B, Mahadevan J, Murthy P, Purushottam M, Viswanath B, Jain S, Devarbhavi H, Mysore Visweswariah A. Hypomethylation of Long Interspersed Nucleotide Elements and Aldehyde Dehydrogenase in Patients of Alcohol Use Disorder with Cirrhosis. DNA Cell Biol 2023. [PMID: 37367217 DOI: 10.1089/dna.2022.0669] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
Alcohol use disorder (AUD) and cirrhosis are key outcomes of excessive alcohol use, and a genetic influence in these outcomes is increasingly recognized. While 80-90% of heavy alcohol users show evidence of fatty liver, only 10-20% progress to cirrhosis. There is currently no clear understanding of the causes of this difference in progression. The aim of this study is to evaluate genetics and epigenetics at the aldehyde dehydrogenase (ALDH2) locus in patients with AUD and liver complications. Study participants were inpatients from the clinical services of Gastroenterology and Psychiatry at St. John's Medical College Hospital (SJMCH) and the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India. Men diagnosed as having AUD with cirrhosis (AUDC+ve, N = 136) and AUD without cirrhosis (AUDC-ve, N = 107) were assessed. FibroScan/sonographic evidence was used to rule out fibrosis in the AUDC-ve group. Genomic DNA was used for genotyping at the ALDH2 (rs2238151) locus. A subset of 89 samples was used for DNA methylation (AUDC+ve, N = 44; and AUDC-ve, N = 45) analysis at long interspersed nucleotide element 1 (LINE-1) and ALDH2 cytosine-phosphate-guanine (CpG) loci by pyrosequencing. ALDH2 DNA methylation was significantly lower in the AUDC+ve group compared with the AUDC-ve group (p < 0.001). Lower methylation was associated with a risk allele (T) of the ALDH2 locus (rs2238151) (p = 0.01). Global (LINE-1) DNA methylation levels were also significantly lower in the AUDC+ve group compared with the AUDC-ve group (p = 0.01). Compromised global methylation (LINE-1) and hypomethylation at the ALDH2 gene was observed in patients with cirrhosis compared with those without cirrhosis. DNA methylation could be explored as a biomarker for cirrhosis and liver complications.
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Affiliation(s)
- Bhagyalakshmi Shankarappa
- Department of Psychiatry, St. John's Medical College Hospital, Bangalore, India
- Molecular Genetics Laboratory, Department of Psychiatry, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Jayant Mahadevan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Meera Purushottam
- Molecular Genetics Laboratory, Department of Psychiatry, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Biju Viswanath
- Molecular Genetics Laboratory, Department of Psychiatry, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Sanjeev Jain
- Molecular Genetics Laboratory, Department of Psychiatry, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Harshad Devarbhavi
- Department of Gastroenterology, St. John's Medical College Hospital, Bangalore, India
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Mazumdar P, Zavala G, Aslam F, Muliyala KP, Chaturvedi SK, Kandasamy A, Nizami A, Ul Haq B, Kellar I, Jackson C, Thomson H, McDaid D, Siddiqi K, Hewitt C, Siddiqi N, Gilbody S, Murthy P, Dadirai Mdege N. IMPACT smoking cessation support for people with severe mental illness in South Asia (IMPACT 4S): A protocol for a randomised controlled feasibility trial of a combined behavioural and pharmacological support intervention. PLoS One 2023; 18:e0287185. [PMID: 37315070 DOI: 10.1371/journal.pone.0287185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 05/30/2023] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION The prevalence of smoking is high among people living with severe mental illness (SMI). Evidence on feasibility, acceptability and effectiveness of smoking cessation interventions among smokers with SMI is lacking, particularly in low- and middle-income countries. We aim to test the feasibility and acceptability of delivering an evidence-based intervention,i.e., the IMPACT smoking cessation support for people with severe mental illness in South Asia (IMPACT 4S) intervention that is a combination of behavioural support and smoking cessation pharmacotherapies among adult smokers with SMI in India and Pakistan. We will also test the feasibility and acceptability of evaluating the intervention in a randomised controlled trial. METHODS We will conduct a parallel, open label, randomised controlled feasibility trial among 172 (86 in each country) adult smokers with SMI in India and Pakistan. Participants will be allocated 1:1 to either Brief Advice (BA) or the IMPACT 4S intervention. BA comprises a single five-minute BA session on stopping smoking. The IMPACT 4S intervention comprises behavioural support delivered in upto 15 one-to-one, face-to-face or audio/video, counselling sessions, with each session lasting between 15 and 40 minutes; nicotine gum and/or bupropion; and breath carbon monoxide monitoring and feedback. Outcomes are recruitment rates, reasons for ineligibility/non-participation/non-consent of participants, length of time required to achieve required sample size, retention in study and treatments, intervention fidelity during delivery, smoking cessation pharmacotherapy adherence and data completeness. We will also conduct a process evaluation. RESULTS Study will address- uncertainty about feasibility and acceptability of delivering smoking cessation interventions, and ability to conduct smoking cessation trials, among adult smokers with SMI in low- and middle-income countries. CONCLUSIONS This is to inform further intervention adaptation, and the design and conduct of future randomised controlled trials on this topic. Results will be disseminated through peer-review articles, presentations at national, international conferences and policy-engagement forums. TRIAL REGISTRATION ISRCTN34399445 (Updated 22/03/2021), ISRCTN Registry https://www.isrctn.com/.
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Affiliation(s)
- Papiya Mazumdar
- Department of Health Sciences, University of York, York, United Kingdom
- School of Politics and International Studies, University of Leeds, Leeds, United Kingdom
| | - Gerardo Zavala
- Department of Health Sciences, University of York, York, United Kingdom
| | - Faiza Aslam
- Institute of Psychiatry, Rawalpindi, Pakistan
| | | | | | - Arun Kandasamy
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Asad Nizami
- Institute of Psychiatry, Rawalpindi, Pakistan
| | - Baha Ul Haq
- Institute of Psychiatry, Rawalpindi, Pakistan
| | - Ian Kellar
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Cath Jackson
- Department of Health Sciences, University of York, York, United Kingdom
- Valid Research Ltd, Wetherby, United Kingdom
| | | | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, Heslington, United Kingdom
| | - Catherine Hewitt
- Department of Health Sciences, University of York, York, United Kingdom
| | - Najma Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, Heslington, United Kingdom
| | - Simon Gilbody
- Department of Health Sciences, University of York, York, United Kingdom
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
- Hull York Medical School, Heslington, United Kingdom
| | - Pratima Murthy
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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Sharma P, Cheah NP, Kaur J, Sathiya Kumar S, Rao V, Morsed FA, Choo MYB, Murthy P. Physical and chemical characterization of smokeless tobacco products in India. Sci Rep 2023; 13:8901. [PMID: 37264008 PMCID: PMC10235085 DOI: 10.1038/s41598-023-35455-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 05/18/2023] [Indexed: 06/03/2023] Open
Abstract
The rapid proliferation of smokeless tobacco (SLT) in India has occurred without adequate information on the possible dangers and toxicity of these products. Tobacco flavors as well as nicotine (both protonated and un-protonated) are responsible for health dangers and addiction. The study aimed to offer information on the physical characteristics of commonly used smokeless tobacco products (including microscopic analysis), along with nicotine content (both total and un-protonated), pH, moisture, and flavors. The Standard Operating Procedures (SOPs) validated by the World Health Organization (WHO) recognized Tobacco Testing Laboratory TobLabNet) were applied for the analysis of various constituents of the SLTs. The microscopic analysis indicated that some of the SLT products like khaini were finely processed and available in filter pouches for users' convenience and prolonged use leading to prolonged retention and addiction potential. Nicotine absorption and availability (both protonated and un-protonated) are affected by moisture and pH. Essences provide a pleasant aroma and flavor, with an increased risk of misuse and other health problems. Few chewing tobacco and Zarda had the lowest levels of un-protonated nicotine (0.10-0.52% and 0.15-0.21%, respectively), whereas Gul, Gudhaku, and Khaini had the highest levels, ranging from 95.33 to 99.12%. Moisture and pH ranged from 4.54 to 50.19% and 5.25-10.07 respectively. Menthol (630.74-9681.42 µg/g) was the most popular flavour, followed by Eucalyptol (118.16-247.77 µg/g) and camphor (148.67 and 219.317 µg/g). SLT's health concerns and addiction dangers are exacerbated by the high proportion of bioavailable nicotine coupled with flavors. The findings of this study have important implications for the regulation and use of SLT in countries where use of SLT is prevalent.
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Affiliation(s)
- Priyamvada Sharma
- Department of Clinical Psychopharmacology and Neurotoxicology and Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHNAS), Bangalore, India.
| | - Nuan Ping Cheah
- Director Cigarette Testing Laboratory, Applied Sciences Group, Health Sciences Authority, 11 Outram Road, Singapore, Singapore
| | - Jagdish Kaur
- Regional Adviser (Tobacco Free Initiative) Department of Healthier populations and Noncommunicable Diseases, WHO Regional Office for South-East Asia, World Health House, I.P. Estate, M.G. Road, New Delhi, India
| | - Sandhya Sathiya Kumar
- Toxicology Laboratory, Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHNAS), Bangalore, India
| | - Vijayashree Rao
- Toxicology Laboratory, Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHNAS), Bangalore, India
| | - Faridatul Akmam Morsed
- Cigarette Testing Laboratory, Pharmaceutical Division, Applied Science Group, Health Sciences Authority, 11 Outram Road, Singapore, 169078, Singapore
| | - Michelle Yong Bing Choo
- Cigarette Testing Laboratory, Pharmaceutical Division, Applied Science Group, Health Sciences Authority, 11 Outram Road, Singapore, 169078, Singapore
| | - Pratima Murthy
- Director and Senior Professor of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India
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Arasappa R, Chithra NK, Kulkarni KR, Muliyala KP, Murthy P, Kesavan M. Gender differences in the young-onset persistent delusional disorder. Asian J Psychiatr 2023; 86:103653. [PMID: 37270876 DOI: 10.1016/j.ajp.2023.103653] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/06/2023]
Abstract
We conducted a retrospective chart review to examine the gender differences in young onset Persistent Delusional Disorder (PDD) subjects (N = 236) with onset of illness before the age of 30 years. Gender differences in marital and employment status were significant (p-0.001). Delusion of infidelity and erotomania were more common in females, while males had more body dysmorphic and persecutory delusions (X2-20.45, p-0.009). Males had more substance dependence (X2-21.31, p < 0.001), as well as a family history of substance abuse and PDD (X2-18.5, p < 0.01). To conclude, gender differences in PDD comprised some psychopathology, co-morbidity, and family history among those with young onset PDD.
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Affiliation(s)
- Rashmi Arasappa
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.
| | - Nellai K Chithra
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - Krishna Prasad Muliyala
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Muralidharan Kesavan
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
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20
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Narayanan G, Murthy P. Ethics of qualitative research in substance use disorders. Asian J Psychiatr 2023; 85:103617. [PMID: 37209544 DOI: 10.1016/j.ajp.2023.103617] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/22/2023]
Abstract
Ethics in substance use disorder research has evolved through the years into two distinct school of thoughts, including neuro-ethics and social ethics. Qualitative methods of conducting studies provide rich descriptive knowledge of underlying processes in use of substances, although their governing ethical principles and decision-making are fairly blurred. By incorporating case studies, in-depth interviews, focus groups or visual methods, substance use disorder research can be considerably enhanced. The present paper examines features of conducting qualitative research among substance users and the ethical frameworks that one needs to be mindful of. Understanding potential dilemmas, pitfalls, and challenges in conducting qualitative research among individuals with substance use disorders would be a useful way to build on the body of qualitative research.
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Affiliation(s)
- Gitanjali Narayanan
- Department of Clinical Psychology, 3rd Floor, MV Govindaswamy Centre, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Pratima Murthy
- Department of Psychiatry & Director, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru 560029, India
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Gangadhar B, Kumar CN, Sadh K, Manjunatha N, Math SB, Kalaivanan RC, Rao GN, Parthasarathy R, Chand PK, Chandra PS, Thirthalli J, Murthy P, Varghese M, Mathur A, Bairy BK, Kishore C, Gowda GS, Basvaraju V, Harihara SN, Isaac MK, Chaturvedi S. Mental Health Programme in India: Has the tide really turned? Indian J Med Res 2023; 157:387-394. [PMID: 37955215 PMCID: PMC10443714 DOI: 10.4103/ijmr.ijmr_2217_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Indexed: 11/14/2023] Open
Abstract
Mental disorders in India form a major public health concern and the efforts to tackle these dates back to four decades, by way of the National Mental Health Programme (NMHP) and its operational arm, the District Mental Health Programme (DMHP). Although the progress of NMHP (and DMHP) was relatively slower till recently, the last 4-5 years have seen rapid strides with several initiatives, including (i) expansion of DMHPs to 90 per cent of the total districts of the country, (ii) the National Mental Health Policy and (iii) strengthening the Mental Health Legislation by way of providing explicit provisions for rights of persons with mental illnesses. Among others, factors responsible for this accelerated growth include the easily accessible digital technology as well as judicial activism. Federal and State cooperation is another notable feature of this expansion. In this review, the authors summarize the available information on the evolution of implementation and research aspects related to India's NMHP over the years and provide a case for the positive turn of events witnessed in the recent years. However, the authors caution that these are still baby steps and much more remains to be done.
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Affiliation(s)
- B.N. Gangadhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | | | - Kamaldeep Sadh
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Rakesh Chander Kalaivanan
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Girish N. Rao
- Department of Epidemiology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Rajani Parthasarathy
- Department of Health & Family Welfare, Government of Karnataka, Bengaluru, Karnataka, India
| | - Prabhat K. Chand
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Prabha S. Chandra
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Alok Mathur
- General of Health Services, Ministry of Health & Family Welfare, Government of India, New Delhi, India
| | - Bhavya K. Bairy
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Chethana Kishore
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Guru S. Gowda
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Vinay Basvaraju
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | | | - Mohan K. Isaac
- Department of Psychiatry, University of Western Australia, Perth, Australia
| | - S.K. Chaturvedi
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
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Basu D, Ghosh A, Naskar C, Balachander S, Fernandes G, Vaidya N, Kumaran K, Krishna M, Barker GJ, Sharma E, Murthy P, Holla B, Jain S, Orfanos DP, Kalyanram K, Purushottam M, Bharath RD, Varghese M, Thennarasu K, Chakrabarti A, Singh RL, Singh RL, Nanjayya SB, Ahuja CK, Kartik K, Krishnaveni G, Kuriyan R, Kurpad SS, Desrivieres S, Iyengar U, Zhang Y, Hickman M, Spiers A, Toledano M, Schumann G, Benegal V. Risk clustering and psychopathology from a multi-center cohort of Indian children, adolescents, and young adults. Dev Psychopathol 2023; 35:800-808. [PMID: 35393927 DOI: 10.1017/s0954579422000050] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Developmental adversities early in life are associated with later psychopathology. Clustering may be a useful approach to group multiple diverse risks together and study their relation with psychopathology. To generate risk clusters of children, adolescents, and young adults, based on adverse environmental exposure and developmental characteristics, and to examine the association of risk clusters with manifest psychopathology. Participants (n = 8300) between 6 and 23 years were recruited from seven sites in India. We administered questionnaires to elicit history of previous exposure to adverse childhood environments, family history of psychiatric disorders in first-degree relatives, and a range of antenatal and postnatal adversities. We used these variables to generate risk clusters. Mini-International Neuropsychiatric Interview-5 was administered to evaluate manifest psychopathology. Two-step cluster analysis revealed two clusters designated as high-risk cluster (HRC) and low-risk cluster (LRC), comprising 4197 (50.5%) and 4103 (49.5%) participants, respectively. HRC had higher frequencies of family history of mental illness, antenatal and neonatal risk factors, developmental delays, history of migration, and exposure to adverse childhood experiences than LRC. There were significantly higher risks of any psychiatric disorder [Relative Risk (RR) = 2.0, 95% CI 1.8-2.3], externalizing (RR = 4.8, 95% CI 3.6-6.4) and internalizing disorders (RR = 2.6, 95% CI 2.2-2.9), and suicidality (2.3, 95% CI 1.8-2.8) in HRC. Social-environmental and developmental factors could classify Indian children, adolescents and young adults into homogeneous clusters at high or low risk of psychopathology. These biopsychosocial determinants of mental health may have practice, policy and research implications for people in low- and middle-income countries.
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Affiliation(s)
- Debasish Basu
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Abhishek Ghosh
- Drug Deaddiction and Treatment Center, Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Chandrima Naskar
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Srinivas Balachander
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Gwen Fernandes
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nilakshi Vaidya
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
- Centre for Population Neuroscience and Precision Medicine, Charité Mental Health, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
| | - Kalyanaraman Kumaran
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Murali Krishna
- Foundation for Research and Advocacy in Mental Health, Mysore, India
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Eesha Sharma
- Department of Child & Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Bharath Holla
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sanjeev Jain
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Kartik Kalyanram
- Rishi Valley, Rural Health Centre, Madanapalle, Andhra Pradesh, India
| | - Meera Purushottam
- Molecular Genetics Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Kandavel Thennarasu
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Amit Chakrabarti
- Centre on Non-Communicable Diseases Division of Non-Communicable Diseases (NCD) Indian Council of Medical Research (ICMR), Kolkata, India
| | - Rajkumar Lenin Singh
- Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Roshan Lourembam Singh
- Department of Psychology, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | | | - Chirag Kamal Ahuja
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Kamakshi Kartik
- Rishi Valley, Rural Health Centre, Madanapalle, Andhra Pradesh, India
| | - Ghattu Krishnaveni
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, Bangalore, India
| | - Sunita Simon Kurpad
- Department of Psychiatry & Department of Medical Ethics, St. John's Medical College & Hospital, Bangalore, India
| | - Sylvane Desrivieres
- Centre for Population Neuroscience and Precision Medicine, MRC Social, Genetic, Developmental Psychiatry Centre, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Udita Iyengar
- Centre for Population Neuroscience and Precision Medicine, MRC Social, Genetic, Developmental Psychiatry Centre, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Yuning Zhang
- Centre for Population Neuroscience and Precision Medicine, MRC Social, Genetic, Developmental Psychiatry Centre, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | | | - Alex Spiers
- Department for Epidemiology and Biostatistics, School of Public Health, Imperial College of Science, London, UK
| | - Mireille Toledano
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Gunter Schumann
- Centre for Population Neuroscience and Precision Medicine, Charité Mental Health, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychiatry and Psychotherapy and PONS Centre, Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Vivek Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
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Vaidya N, Holla B, Heron J, Sharma E, Zhang Y, Fernandes G, Iyengar U, Spiers A, Yadav A, Das S, Roy S, Ahuja CK, Barker GJ, Basu D, Bharath RD, Hickman M, Jain S, Kalyanram K, Kartik K, Krishna M, Krishnaveni G, Kumaran K, Kuriyan R, Murthy P, Papadopoulos Orfanos D, Purushottam M, Kurpad SS, Singh L, Singh R, Subodh BN, Toledano M, Walter H, Desrivières S, Chakrabarti A, Benegal V, Schumann G. Neurocognitive Analysis of Low-level Arsenic Exposure and Executive Function Mediated by Brain Anomalies Among Children, Adolescents, and Young Adults in India. JAMA Netw Open 2023; 6:e2312810. [PMID: 37171822 PMCID: PMC10182429 DOI: 10.1001/jamanetworkopen.2023.12810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/20/2023] [Indexed: 05/13/2023] Open
Abstract
Importance Arsenic, a contaminant of groundwater and irrigated crops, is a global public health hazard. Exposure to low levels of arsenic through food extends well beyond the areas with high arsenic content in water. Objective To identify cognitive impairments following commonly prevalent low-level arsenic exposure and characterize their underlying brain mechanisms. Design, Setting, and Participants This multicenter population-based cohort study analyzed cross-sectional data of the Indian Consortium on Vulnerability to Externalizing Disorders and Addictions (cVEDA) cohort, recruited between November 4, 2016, and May 4, 2019. Participants aged 6 to 23 years were characterized using deep phenotyping measures of behavior, neuropsychology, psychopathology, brain neuroimaging, and exposure to developmental adversities and environmental neurotoxins. All analyses were performed between June 1, 2020, and December 31, 2021. Exposure Arsenic levels were measured in urine as an index of exposure. Main Outcomes and Measures Executive function measured using the cVEDA neuropsychological battery, gray matter volume (GMV) from T1-weighted magnetic resonance imaging, and functional network connectivity measures from resting state functional magnetic resonance imaging. Results A total of 1014 participants aged 6 to 23 years (589 male [58.1%]; mean [SD] age, 14.86 [4.79] years) were included from 5 geographic locations. Sparse-partial least squares analysis was used to describe a negative association of arsenic exposure with executive function (r = -0.12 [P = 5.4 × 10-4]), brain structure (r = -0.20 [P = 1.8 × 10-8]), and functional connectivity (within network, r = -0.12 [P = 7.5 × 10-4]; between network, r = -0.23 [P = 1.8 × 10-10]). Alterations in executive function were partially mediated by GMV (b = -0.004 [95% CI, -0.007 to -0.002]) and within-network functional connectivity (b = -0.004 [95% CI, -0.008 to -0.002]). Socioeconomic status and body mass index moderated the association between arsenic and GMV, such that the association was strongest in participants with lower socioeconomic status and body mass index. Conclusions and Relevance The findings of this cross-sectional study suggest that low-level arsenic exposure was associated with alterations in executive functioning and underlying brain correlates. These results indicate potential detrimental consequences of arsenic exposure that are below the currently recommended guidelines and may extend beyond endemic risk areas. Precision medicine approaches to study global mental health vulnerabilities highlight widespread but potentially modifiable risk factors and a mechanistic understanding of the impact of low-level arsenic exposure on brain development.
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Affiliation(s)
- Nilakshi Vaidya
- Centre for Population Neuroscience and Precision Medicine, Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Bharath Holla
- Department of Psychiatry and Integrative Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Jon Heron
- Centre for Public Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Eesha Sharma
- Department of Child & Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Yuning Zhang
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Gwen Fernandes
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Udita Iyengar
- Institute of Psychology, Psychiatry & Neuroscience, King’s College London, London, United Kingdom
| | - Alex Spiers
- MRC (Medical Research Council) Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Anupa Yadav
- Indian Council of Medical Research–Centre on Noncommunicable Diseases, Kolkata, India
| | - Surajit Das
- Indian Council of Medical Research–Centre on Noncommunicable Diseases, Kolkata, India
| | - Sanjit Roy
- Indian Council of Medical Research–Centre on Noncommunicable Diseases, Kolkata, India
| | - Chirag K. Ahuja
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Gareth J. Barker
- Department of Neuroimaging, Institute of Psychology, Psychiatry & Neuroscience, King’s College London, London, United Kingdom
| | - Debasish Basu
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sanjeev Jain
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | | | - Murali Krishna
- Foundation for Research and Advocacy in Mental Health, Mysore, India
| | - Ghattu Krishnaveni
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | | | - Rebecca Kuriyan
- Division of Nutrition, St John’s Research Institute, Bangalore, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Dimitri Papadopoulos Orfanos
- NeuroSpin, Commissariat à l’Énergie Atomique et aux Énergies Alternatives, Université Paris-Saclay, Paris, France
| | - Meera Purushottam
- Molecular Genetics Laboratory, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sunita Simon Kurpad
- Department of Psychiatry, St John’s Medical College and Hospital, Bangalore, India
- Department of Medical Ethics, St John’s Medical College and Hospital, Bangalore, India
| | - Lenin Singh
- Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Roshan Singh
- Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - B. N. Subodh
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mireille Toledano
- MRC (Medical Research Council) Centre for Environment and Health, Imperial College London, London, United Kingdom
- Mohn Centre for Children’s Health and Wellbeing, School of Public Health, Imperial College London, London, United Kingdom
| | - Henrik Walter
- Psychiatry, Psychiatric Neuroscience and Neurophilosophy, Research Division of Mind and Brain, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sylvane Desrivières
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Amit Chakrabarti
- Indian Council of Medical Research–Centre on Noncommunicable Diseases, Kolkata, India
| | - Vivek Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Gunter Schumann
- Centre for Population Neuroscience and Precision Medicine, Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Centre for Population Neuroscience and Precision Medicine, Institute for Science and Technology of Brain-Inspired Intelligence, Fudan University, Shanghai, China
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24
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Thekkumkara S, Jagannathan A, Muliyala KP, Joseph A, Murthy P. Feasibility testing of a peer support programme for prisoners with common mental disorders and substance use. Crim Behav Ment Health 2023. [PMID: 37038899 DOI: 10.1002/cbm.2287] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The prevalence of mental disorders and substance use among prisoners is high. Convicted prisoners of 'good behaviour' can be part of a peer support system in prisons. AIM To evaluate the feasibility of a peer support programme for prisoners with common mental disorders and substance use in prison. METHOD The study used a mixed method research design, with a quasi-experimental approach (single group pre-post without control). It was conducted in two phases: Phase I. Thirty-five peers/convicted prisoners were recruited through advertisements on the prisoners' community radio station. Volunteers with good behaviour reports were given training over 5 days to recognise mental and substance use disorders and provide basic peer support in prison; their attitudes and knowledge were tested before and after the training. PHASE II Feasibility of the peer support programme was tested by (i) recording the number of cases identified and referred, (ii) pre- and post-evaluation of well-being, coping, and symptom severity of those supported and (iii) evaluating qualitatively the experience of the peer supporters and service users. RESULTS Thirty-five peer supporters identified 49 cases over 3 months. These cases showed significant improvement in well-being (Z -1.962; p < 0.050) and reduction in symptom severity (Z -1.913; 0.056). There was a significant improvement in the peers supporters' self-esteem from pre- to post-training (t -3.31; p < 0.002), improvement in their benevolence (t -4.37; p < 0.001) and a significant reduction in their negative attitudes to mental illness (Z -3.518; p < 0.001). A thematic model of peer support encompassed self-experienced benefits for the peer supporter, wider recognition of peer supporters in the prison, challenges to this kind of support, experience of training and visions for future work. CONCLUSION The peer support programme was experienced positively by the peer-supporters and supported. Common mental disorders, substance use and suicidality were recognised and appropriately referred. A full-scale evaluation of this promising programme is warranted.
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Affiliation(s)
| | | | | | - Ambi Joseph
- MSW, Social Worker, Thiruvananthapuram, Kerala, India
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Sharma E, Ravi GS, Kumar K, Thennarasu K, Heron J, Hickman M, Vaidya N, Holla B, Rangaswamy M, Mehta UM, Krishna M, Chakrabarti A, Basu D, Nanjayya SB, Singh RL, Lourembam R, Kumaran K, Kuriyan R, Kurpad SS, Kartik K, Kalyanram K, Desrivieres S, Barker G, Orfanos DP, Toledano M, Purushottam M, Bharath RD, Murthy P, Jain S, Schumann G, Benegal V. Growth trajectories for executive and social cognitive abilities in an Indian population sample: Impact of demographic and psychosocial determinants. Asian J Psychiatr 2023; 82:103475. [PMID: 36736106 DOI: 10.1016/j.ajp.2023.103475] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/18/2023] [Indexed: 01/21/2023]
Abstract
Cognitive abilities are markers of brain development and psychopathology. Abilities, across executive, and social domains need better characterization over development, including factors that influence developmental change. This study is based on the cVEDA [Consortium on Vulnerability to Externalizing Disorders and Addictions] study, an Indian population based developmental cohort. Verbal working memory, visuo-spatial working memory, response inhibition, set-shifting, and social cognition (faux pas recognition and emotion recognition) were cross-sectionally assessed in > 8000 individuals over the ages 6-23 years. There was adequate representation across sex, urban-rural background, psychosocial risk (psychopathology, childhood adversity and wealth index, i.e. socio-economic status). Quantile regression was used to model developmental change. Age-based trajectories were generated, along with examination of the impact of determinants (sex, childhood adversity, and wealth index). Development in both executive and social cognitive abilities continued into adulthood. Maturation and stabilization occurred in increasing order of complexity, from working memory to inhibitory control to cognitive flexibility. Age related change was more pronounced for low quantiles in response inhibition (β∼4 versus =2 for higher quantiles), but for higher quantiles in set-shifting (β > -1 versus -0.25 for lower quantiles). Wealth index had the largest influence on developmental change across cognitive abilities. Sex differences were prominent in response inhibition, set-shifting and emotion recognition. Childhood adversity had a negative influence on cognitive development. These findings add to the limited literature on patterns and determinants of cognitive development. They have implications for understanding developmental vulnerabilities in young persons, and the need for providing conducive socio-economic environments.
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Affiliation(s)
- Eesha Sharma
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India.
| | - G S Ravi
- Department of Health Data Science, University of Liverpool, United Kingdom
| | - Keshav Kumar
- Department of Mental Health and Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Kandavel Thennarasu
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Nilakshi Vaidya
- PONS Centre, Charité Mental Health, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Germany
| | - Bharath Holla
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Madhavi Rangaswamy
- Department of Psychology, CHRIST (Deemed to be University), Bengaluru, India
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Murali Krishna
- Foundation for Research and Advocacy in Mental Health, Mysuru, India
| | | | - Debashish Basu
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Roshan Lourembam
- Department of Psychology, Regional Institute of Medical Sciences, Imphal, India
| | - Kalyanaraman Kumaran
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom & Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysuru, India
| | - Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, Bengaluru, India
| | - Sunita Simon Kurpad
- Department of Psychiatry & Department of Medical Ethics, St. John's Medical College & Hospital, Bengaluru, India
| | - Kamakshi Kartik
- Rishi Valley Rural Health Centre, Madanapalle, Chittoor, India
| | | | - Sylvane Desrivieres
- Centre for Population Neuroscience and Precision Medicine, Institute of Psychology, Psychiatry & Neuroscience, MRC SGDP Centre, King's College London, United Kingdom
| | - Gareth Barker
- Department of Neuroimaging, Institute of Psychology, Psychiatry & Neuroscience, King's College London, United Kingdom
| | | | - Mireille Toledano
- MRC Centre for Environment and Health, School of Public Health, Imperial College, London, United Kingdom
| | - Meera Purushottam
- Molecular Genetics Laboratory, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Sanjeev Jain
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Gunter Schumann
- PONS Centre, Charité Mental Health, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Germany; Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Vivek Benegal
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Gazula H, Rootes-Murdy K, Holla B, Basodi S, Zhang Z, Verner E, Kelly R, Murthy P, Chakrabarti A, Basu D, Bhagyalakshmi Nanjayya S, Lenin Singh R, Lourembam Singh R, Kalyanram K, Kartik K, Kalyanaraman K, Ghattu K, Kuriyan R, Kurpad SS, Barker GJ, Bharath RD, Desrivieres S, Purushottam M, Orfanos DP, Sharma E, Hickman M, Toledano M, Vaidya N, Banaschewski T, Bokde ALW, Flor H, Grigis A, Garavan H, Gowland P, Heinz A, Brühl R, Martinot JL, Paillére Martinot ML, Artiges E, Nees F, Paus T, Poustka L, Fröhner JH, Robinson L, Smolka MN, Walter H, Winterer J, Whelan R, Turner JA, Sarwate AD, Plis SM, Benegal V, Schumann G, Calhoun VD. Federated Analysis in COINSTAC Reveals Functional Network Connectivity and Spectral Links to Smoking and Alcohol Consumption in Nearly 2,000 Adolescent Brains. Neuroinformatics 2023; 21:287-301. [PMID: 36434478 DOI: 10.1007/s12021-022-09604-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 11/27/2022]
Abstract
With the growth of decentralized/federated analysis approaches in neuroimaging, the opportunities to study brain disorders using data from multiple sites has grown multi-fold. One such initiative is the Neuromark, a fully automated spatially constrained independent component analysis (ICA) that is used to link brain network abnormalities among different datasets, studies, and disorders while leveraging subject-specific networks. In this study, we implement the neuromark pipeline in COINSTAC, an open-source neuroimaging framework for collaborative/decentralized analysis. Decentralized exploratory analysis of nearly 2000 resting-state functional magnetic resonance imaging datasets collected at different sites across two cohorts and co-located in different countries was performed to study the resting brain functional network connectivity changes in adolescents who smoke and consume alcohol. Results showed hypoconnectivity across the majority of networks including sensory, default mode, and subcortical domains, more for alcohol than smoking, and decreased low frequency power. These findings suggest that global reduced synchronization is associated with both tobacco and alcohol use. This proof-of-concept work demonstrates the utility and incentives associated with large-scale decentralized collaborations spanning multiple sites.
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Affiliation(s)
- Harshvardhan Gazula
- Martinos Center for Biomedical Imaging, MGH and Harvard Medical School, Boston, USA.
| | - Kelly Rootes-Murdy
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Bharath Holla
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
- Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
| | - Sunitha Basodi
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Zuo Zhang
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College London, London, SE5 8AF, United Kingdom
| | - Eric Verner
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Ross Kelly
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | | | - Debasish Basu
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | | | - Rajkumar Lenin Singh
- Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Roshan Lourembam Singh
- Department of Psychology, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | | | | | | | - Krishnaveni Ghattu
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, Bengaluru, India
| | - Sunita Simon Kurpad
- Department of Psychiatry & Department of Medical Ethics, St. John's Medical College & Hospital, Bangalore, India
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, NIMHANS, Bengaluru, India
| | - Sylvane Desrivieres
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College London, London, SE5 8AF, United Kingdom
| | | | | | - Eesha Sharma
- Department of Child & Adolescent Psychiatry, NIMHANS, Bengaluru, India
| | | | - Mireille Toledano
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Nilakshi Vaidya
- Centre for Addiction Medicine, NIMHANS, Bengaluru, India
- Centre for Population Neuroscience and Precision Medicine (PONS), Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, 68159, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, 68131, Germany
| | | | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont, 05405, USA
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, United Kingdom
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Rüdiger Brühl
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Berlin, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 "Trajectoires développementales en psychiatrie"; Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli;, Gif-sur-Yvette, France
| | - Marie-Laure Paillére Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 "Trajectoires développementales en psychiatrie"; Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli;, Gif-sur-Yvette, France
- AP-HP. Sorbonne Université, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Eric Artiges
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 "Trajectoires développementales en psychiatrie"; Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli;, Gif-sur-Yvette, France
- Psychiatry Department, EPS Barthélémy Durand, Etampes, France
| | - Frauke Nees
- Centre for Population Neuroscience and Precision Medicine (PONS), Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, 68159, Germany
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
| | - Tomás Paus
- Department of Psychiatry, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
- Departments of Psychiatry and Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, Göttingen, 37075, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Lauren Robinson
- Department of Psychological Medicine, Section for Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jeanne Winterer
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Jessica A Turner
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Anand D Sarwate
- Department of Electrical and Computer Engineering, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Sergey M Plis
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
- Department of Computer Science, Georgia State University, Atlanta, GA, USA
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Gunter Schumann
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology & Neuroscience, SGDP Centre, King's College London, London, SE5 8AF, United Kingdom
- Centre for Population Neuroscience and Precision Medicine (PONS), Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, P.R. China
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
- Department of Psychology, Georgia State University, Atlanta, GA, USA
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Sharma AK, Shadakshari D, Chand P, Murthy P. Design, development and pilot testing of 'Quest', a smartphone-based relapse prevention app for patients with alcohol dependence. Asian J Psychiatr 2023; 83:103572. [PMID: 37019043 DOI: 10.1016/j.ajp.2023.103572] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/15/2023] [Accepted: 03/25/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE To design, develop and pilot the 'Quest' app for smartphone-based relapse prevention for patients diagnosed with alcohol dependence syndrome (ADS). METHODS Principles of relapse prevention and motivation enhancement were used to develop the Quest App. Four addiction psychiatrists reviewed the app using the "app evaluation framework". Thirty patients (> 18 yrs age) diagnosed with ADS, who had an Android smartphone, were fluent in writing and reading English and agreed to use the app regularly for the next three months were enrolled in this study. After initial treatment for intoxication/withdrawal and with written consent, patients in the study group (TAUQ) were requested to download the Quest application from a downloadable installation file. The usability and acceptability of Quest App amongst TAUQ patients was evaluated using the usability section of the mHealth App Usability Questionnaire (MAUQ). The short-term effectiveness at the end of three months was compared between TAUQ and comparison group who received Treatment as Usual (TAU). RESULTS Both acceptability (65 %) and usability (5.8 out of 7) of the app were high. The patient groups (with or without Quest app) showed a significant reduction in drinking at 30, 60, and 90 days follow-up compared with their baseline number of drinking days. There was no significant difference between the two groups (with or without Quest App) in the median number of lapses and the median number of days of heavy drinking. CONCLUSIONS This is the first attempt to develop a smartphone app and test its feasibility in preventing relapse among patients with ADS in the Indian population. Further validation of the app after incorporating feedback and testing on a larger sample size and multiple languages is required.
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Affiliation(s)
- Abhishek Kumar Sharma
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Darshan Shadakshari
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Prabhat Chand
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India.
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
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Ezhumalai S, Shanmugam B, Chand PK, Murthy P. Compliance with Section 7 (2) of the Cigarettes and Other Tobacco Products Act (COTPA) 2003, Ban of Sale of Loose Tobacco, in Karnataka: A Cross-Sectional Study. Indian J Psychol Med 2023; 45:139-145. [PMID: 36925494 PMCID: PMC10011855 DOI: 10.1177/02537176221127139] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Background Banning smoking in public places has considerably reduced the number of smokers. However, the sale of loose tobacco encourages tobacco use. There is limited data on compliance with section 7(2) of the Cigarettes and Other Tobacco Products Act (COTPA), 2003, concerning the ban on loose tobacco sales in India. The aim of this study is to assess the compliance of section 7(2) of COTPA concerning the ban on loose tobacco sales in four selected cities of Karnataka. Methods This community-based study used a cross-sectional design. Two neighboring cities, that is, district headquarter from North (Bidar and Vijayapura) and South (Mandya and Chikkamagaluru) Karnataka were considered for the study. A total of 207 vendors and 204 smokers were selected using time-cluster sampling. Data was collected using observation and interview methods. Semi-structured interview schedules were administered to smokers and vendors. Percentages and frequencies were used to describe the data. Results Most tobacco vendors (92%) and smokers (91%) were unaware of the loose tobacco ban. Most smokers (76%) perceive that buying cigarettes in packets would increase smoking. Most smokers (96%) prefer to buy cigarettes in loose. The sale of loose tobacco was widely prevalent (94%) in the four surveyed cities. Point of sale of loose tobacco includes tea shops (38%), petty shops (31%), pan shops (25%), and bakeries (6%). Conclusion There is a high degree of noncompliance with Section 7 (2) of COTPA, 2003 regarding ban on selling loose tobacco.
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Affiliation(s)
- Sinu Ezhumalai
- Dept. of Psychiatric Social Work, National Institute of Mental Health and NeuroSciences, Bengaluru, Karnataka, India
| | - Backiyaraj Shanmugam
- Dept. of Psychiatric Social Work, National Institute of Mental Health and NeuroSciences, Bengaluru, Karnataka, India
| | - Prabhat Kumar Chand
- Dept. of Psychiatry, Centre for Addiction Medicine, National Institute of Mental Health and NeuroSciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Dept. of Psychiatry, National Institute of Mental Health And NeuroSciences, Bengaluru, Karnataka, India
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29
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Pradeep Kumar P C, Antony S, Murthy P, Thirumoorthy A, Philip M. Association of Social Network Characteristics with Substance Use among College-Going Young Adults: A Cross-Sectional Study. Indian J Psychol Med 2023; 45:155-161. [PMID: 36925503 PMCID: PMC10011842 DOI: 10.1177/02537176221148971] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background Family members, peers, and significant others are part of a college student's social network. This cross-sectional study aimed to Assess substance use prevalence and patterns among college students,Compare the social network characteristics of substance users (SUs) and non-users (NUs), andExplore the association of social factors with substance use. Methods The study involved 902 students from 11 Government and aided private degree colleges. Demographic and clinical data sheet, ASSIST, and Social Network Questionnaire were used to collect the data. Results Prevalence of substance use was 26.9% and higher among males (21.5%). Alcohol (20%) and tobacco (15.5%) were the commonly used substances. SUs' network was composed of unmarried persons (p<0.002), male members (p<0.001), and friends (p<0.001) with substance use. In contrast, the NUs' network comprised parents (p<0.016) and siblings (p<0.001). NUs had a higher number of influential members in the network, whereas SUs had more closeness with members and received higher financial support (p<0.001). Participant's age (OR 1.27), family history of substance use (OR 2.46), parents' occupation (Business: OR 1.79, being employee in the government or industry: OR 1.76),and having three substance-using members in the network (OR .211) were found to be risk factors. Conclusion Social network has an association with substance use among college students. Social-network-based interventions may benefit them.
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Affiliation(s)
- Pradeep Kumar P C
- Psychiatric Social Work, Dept. of Psychiatry, JSS Medical College and Hospital, Mysuru, Karnataka, India
| | - Sojan Antony
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pratima Murthy
- Dept. of Psychiatry and Centre for Addiction Medicine, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - A Thirumoorthy
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Mariamma Philip
- Dept. of Biostatistics, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
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30
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Zavala GA, Haidar-Chowdhury A, Prasad-Muliyala K, Appuhamy K, Aslam F, Huque R, Khalid H, Murthy P, Nizami AT, Rajan S, Shiers D, Siddiqi N, Siddiqi K, Boehnke JR. Prevalence of physical health conditions and health risk behaviours in people with severe mental illness in South Asia: multi-country cross-sectional survey. BJPsych Open 2023; 9:e43. [PMID: 36815449 PMCID: PMC9970179 DOI: 10.1192/bjo.2023.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/24/2023] Open
Abstract
BACKGROUND People with severe mental illness (SMI) die earlier than the general population, primarily because of physical disorders. AIMS We estimated the prevalence of physical health conditions, health risk behaviours, access to healthcare and health risk modification advice in people with SMI in Bangladesh, India and Pakistan, and compared results with the general population. METHOD We conducted a cross-sectional survey in adults with SMI attending mental hospitals in Bangladesh, India and Pakistan. Data were collected on non-communicable diseases, their risk factors, health risk behaviours, treatments, health risk modification advice, common mental disorders, health-related quality of life and infectious diseases. We performed a descriptive analysis and compared our findings with the general population in the World Health Organization (WHO) 'STEPwise Approach to Surveillance of NCDs' reports. RESULTS We recruited 3989 participants with SMI, of which 11% had diabetes, 23.3% had hypertension or high blood pressure and 46.3% had overweight or obesity. We found that 70.8% of participants with diabetes, high blood pressure and hypercholesterolemia were previously undiagnosed; of those diagnosed, only around half were receiving treatment. A total of 47% of men and 14% of women used tobacco; 45.6% and 89.1% of participants did not meet WHO recommendations for physical activity and fruit and vegetable intake, respectively. Compared with the general population, people with SMI were more likely to have diabetes, hypercholesterolemia and overweight or obesity, and less likely to receive tobacco cessation and weight management advice. CONCLUSIONS We found significant gaps in detection, prevention and treatment of non-communicable diseases and their risk factors in people with SMI.
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Affiliation(s)
| | | | - Krishna Prasad-Muliyala
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Faiza Aslam
- Institute of Psychiatry, Rawalpindi Medical University, Pakistan
| | | | - Humaira Khalid
- Institute of Psychiatry, Rawalpindi Medical University, Pakistan
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Asad T Nizami
- Institute of Psychiatry, Rawalpindi Medical University, Pakistan
| | - Sukanya Rajan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - David Shiers
- Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK; Division of Psychology and Mental Health, University of Manchester, UK; and School of Medicine, Keele University, UK
| | - Najma Siddiqi
- Department of Health Sciences, University of York, UK; Hull York Medical School, UK; and Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, UK; and Hull York Medical School, UK
| | - Jan R Boehnke
- Department of Health Sciences, University of York, UK; and School of Health Sciences, University of Dundee, UK
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Kumar P C P, Murthy P, Lohit RP, Hegde S, Chand P, Sethuraman L. Impact of Covid-19 on Caller Characteristics and Quit Rates: Experience of Regional Tobacco Quitline From India. Nicotine Tob Res 2023; 25:247-253. [PMID: 35023566 PMCID: PMC8807263 DOI: 10.1093/ntr/ntac013] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/29/2021] [Accepted: 01/11/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The tobacco epidemic is a major health concern amplified by Covid-19. We aimed to study differences in caller profiles to the regional tobacco quitline services of South India during the Covid-19 pandemic in comparison with the prepandemic. METHOD Using a descriptive cross-sectional research design, we examined registered caller profiles to the quitline between March and July 2019 (Prepandemic N = 7845) and the same months in 2020 (Covid-19 pandemic phase N = 6447) phases. RESULTS The proportion of registered callers with an expressed intent to quit tobacco increased by 1.73 times during pandemic (16.7% versus 9.6%). Health concerns were cited as the major reason (93.25%) to quit tobacco in 2020 as compared to 2019 (88.02%). Cough (28.50%) and psychological difficulties (14.20%) were reported significantly more by RCs in 2020. Self-reported quit rates were significantly higher among RCs in 2020 as compared to 2019 on the quit day (2019-47.37% & 2020-77.54%, p = .001), at one week (2019-25.17% and 2020-56.06%, p = .001) as was one-month continuous abstinence (2019-11.88% and 2020-39.60%, p = .001). CONCLUSION The pandemic resulted in a greater intent to quit among registered callers to the quitline. However, awareness about the quitline services as well as other tobacco cessation services needs to be expanded to reach more tobacco users. IMPLICATIONS Pandemics offer an opportunity to change health risk behaviors. During the Covid-19 pandemic, callers to the tobacco quitline were more motivated to quit tobacco and attributed it to concerns about the health risks from tobacco use, particularly during the pandemic. Quit rates also increased significantly during the pandemic as compared to before. These gains in encouraging tobacco cessation need to be maintained beyond the pandemic by strengthening existing quitlines and other supports for tobacco cessation.
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Affiliation(s)
| | - Pratima Murthy
- National Institute of Mental Health and Neuro Sciences (NIMHANS)
| | - R P Lohit
- National Institute of Mental Health and Neuro Sciences (NIMHANS)
| | - Sudarshan Hegde
- National Institute of Mental Health and Neuro Sciences (NIMHANS)
| | - Prabhat Chand
- National Institute of Mental Health and Neuro Sciences (NIMHANS)
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32
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Lakkireddy SP, Balachander S, Dayalamurthy P, Bhattacharya M, Joseph MS, Kumar P, Kannampuzha AJ, Mallappagari S, Narayana S, Alexander AC, Muthukumaran M, Sheth S, Puzhakkal JC, Ramesh V, Thatikonda NS, Selvaraj S, Ithal D, Sreeraj VS, Mahadevan J, Holla B, Venkatasubramanian G, John JP, Murthy P, Benegal V, Reddy YCJ, Jain S, Viswanath B. Neurocognition and its association with adverse childhood experiences and familial risk of mental illness. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110620. [PMID: 35995305 PMCID: PMC7615105 DOI: 10.1016/j.pnpbp.2022.110620] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022]
Abstract
Environmental factors such as adverse childhood experiences (ACEs) may affect neurocognition, an endophenotype for several mental illnesses. This study examines the effect of ACEs on neurocognitive performance in first-degree relatives (FDRs) of patients with severe mental illness to determine whether familial risk has a moderating effect on the relationship between ACEs and neurocognition. Unaffected FDRs from multiplex families with severe mental illnesses (schizophrenia, bipolar disorder, obsessive-compulsive disorder, or alcohol use disorder) (n = 324) and healthy controls (with no familial risk) (n = 188) underwent neurocognitive tests for processing speed, new learning, working memory and Theory of Mind. ACEs were measured using the WHO ACE-International Questionnaire (ACE-IQ). Regression models were done to predict each neurocognitive domain by the effect of familial risk, ACE-IQ Score and their interaction (familial risk*ACE-IQ score). The main effect of familial risk predicted poor performance in all domains of neurocognition (p < 0.01), and the interaction had a negative association with global neurocognition (β = -0.093, p = 0.009), processing speed (β = -0.109, p = 0.003) and working memory (β = -0.092, p = 0.01). Among the ACEs sub-domains, only maltreatment (specifically the main effect of physical neglect and the interaction effect of sexual abuse with familial risk) predicted poorer neurocognition. In FDRs of schizophrenia and bipolar disorder, only the main effects of familial risk were significantly associated with poorer neurocognition. We conclude that there is a relationship between ACEs (especially maltreatment) and neurocognitive functioning, which is moderated by the familial risk of mental illnesses. Genetic/familial vulnerability may have a stronger association with neurocognition in schizophrenia and bipolar disorder.
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Affiliation(s)
- Sai Priya Lakkireddy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Srinivas Balachander
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
| | - Pavithra Dayalamurthy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Mahashweta Bhattacharya
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Mino Susan Joseph
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Pramod Kumar
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Anand Jose Kannampuzha
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sreenivasulu Mallappagari
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Shruthi Narayana
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Alen Chandy Alexander
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Moorthy Muthukumaran
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sweta Sheth
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Joan C Puzhakkal
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Vinutha Ramesh
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Navya Spurthi Thatikonda
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sowmya Selvaraj
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Dhruva Ithal
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Vanteemar S Sreeraj
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Jayant Mahadevan
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Bharath Holla
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Ganesan Venkatasubramanian
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - John P John
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Pratima Murthy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Vivek Benegal
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Y C Janardhan Reddy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sanjeev Jain
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Biju Viswanath
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
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Badekar A, Rajalu BM, Muliyala KP, Sharma P, Chand PK, Murthy P. Prevalence and severity of tobacco use and access to tobacco cessation among tertiary care psychiatric in-patients in India. Indian J Psychiatry 2022; 64:572-578. [PMID: 36714672 PMCID: PMC9881721 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_405_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 06/18/2022] [Revised: 09/20/2022] [Accepted: 10/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background Rates of smoking in persons with mental illness are reported to be two times higher than those without mental illness in developed countries. We aimed to examine the prevalence and severity of tobacco use, and access to tobacco cessation services among tertiary care psychiatric in-patients in India. Methods In this cross-sectional study, 500 consecutive adult in-patients in tertiary care with ICD 10 diagnoses, F20-59, were administered a sociodemographic and clinical proforma, Clinical Global Impression-Severity scale, Fagerstrom Test for Nicotine Dependence, Tobacco Craving Questionnaire, Reasons for quitting questionnaire, and Smoke Scale-Adults. Urine cotinine levels were estimated in the last 100 patients. Details of tobacco use and cessation interventions provided were obtained. Results Overall prevalence of current tobacco use was 34.00%; 34.3%, 32.6%, 43.6%, and 16.7% in patients of F20-29, F30-39, F40-49, and F50-59 categories, respectively. Males used tobacco products at a significantly higher rate (44.85% vs. 17.58% in females) and were highly dependent. Smokeless tobacco use was reported in 20.5% and 18% of female patients with F20-29 and F30-39 diagnoses, respectively. More than half of the tobacco users were not asked about tobacco use and 89.4% of the users were provided no prior assistance for cessation at the time of assessment. Urinary cotinine levels were significantly greater for those who use smokeless forms than smokers or dual users. Conclusions Nearly a third of psychiatric in-patients are current users of tobacco. Moderate to severe tobacco dependence was observed across psychiatric diagnoses. The assessment and interventions provided were suboptimal.
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Affiliation(s)
- Amol Badekar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Banu Manickam Rajalu
- Department of Nursing, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Krishna Prasad Muliyala
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Priyamvada Sharma
- Department of Clinical Pharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Prabhat Kumar Chand
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
- Department of Director, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Chand PK, Panda U, Mahadevan J, Murthy P. Management of Alcohol Withdrawal Syndrome in Patients with Alcoholic Liver Disease. J Clin Exp Hepatol 2022; 12:1527-1534. [PMID: 36340306 PMCID: PMC9630022 DOI: 10.1016/j.jceh.2022.03.003] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/13/2022] [Indexed: 12/12/2022] Open
Abstract
Alcohol withdrawal syndrome (AWS) is a common condition that is seen in treatment-seeking patients with Alcohol use disorder (AUD) and alcoholic liver disease (ALD). AWS, which typically starts within 4-6 h of the last alcohol use, can range from mild symptoms such as insomnia, tremors, and autonomic hyperactivity to more severe symptoms such as seizures and delirium tremens. Clinical Institute Withdrawal Assessment Scale-Alcohol Revised (CIWA-Ar) is the most commonly used scale to assess AWS in clinical practice. The presence of moderate withdrawal as indicated by a score of more than 8 is an indication for pharmacotherapy. Lorazepam and oxazepam are preferred agents for the management of AWS in the setting of ALD. In severe ALD, benzodiazepines should be used cautiously with monitoring due to the risk of excessive sedation or precipitating hepatic encephalopathy.
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Key Words
- ALD, alcoholic liver disease
- AMPA, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid
- AUD, alcohol use disorder
- AUDIT – C, Alcohol Use Disorder Identification Test – Consumption
- AUDIT, Alcohol Use Disorder Identification Test
- AWS, alcohol withdrawal syndrome
- CIWA – Ar, Clinical Institute Withdrawal Assessment for Alcohol Revised
- CNS, central nervous system
- EtG, ethyl glucuronide
- EtS, ethyl sulphate
- GABA, gamma-aminobutyric acid
- GGT, gamma glutamyl transferase
- HE, hepatic encephalopathy
- MCV, mean corpuscular volume
- NMDA, N-methyl-d-aspartate
- alcohol
- alcoholic liver disease
- assessment
- treatment
- withdrawal
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Affiliation(s)
- Prabhat Kumar Chand
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Udit Panda
- Kalinga Institute of Medical Sciences, Bhubaneshwar, India
| | - Jayant Mahadevan
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Pratima Murthy
- National Institute of Mental Health and Neurosciences, Bangalore, India
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Narasimha VL, Arvind BA, Holla B, Tadepalli R, Kandasamy A, Murthy P. Title of the study: Practice and attitude of doctors towards patients with substance use: A study from south India. Asian J Psychiatr 2022; 77:103247. [PMID: 36084532 DOI: 10.1016/j.ajp.2022.103247] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 08/12/2022] [Accepted: 08/22/2022] [Indexed: 11/25/2022]
Abstract
AIM To evaluate the practice and attitude of doctors towards substance use disorders (SUD) and their management. METHODS Following stratified proportionate random sampling, selected doctors in the south zone of Bengaluru, India, were interviewed face-to-face using a structured questionnaire. RESULTS 150 doctors were interviewed. In their practice, a quarter of patients (median of 27.5 (IQR: 11.45-45) use one or other form of Alcohol, Tobacco or Other Drugs of abuse (ATOD). Doctors, in general, enquire about substance use but do not actively intervene. They have mixed attitudes (both positive and negative) towards persons with SUD. A significant positive correlation was noted between the number of years of experience (post-MBBS) with practices related to "brief-intervention" (p = 0.014) and "concerned and sympathetic" attitudes (p < 0.001). However, a significant negative correlation was observed between the number of years of experience and "substance-specific management" practices (p < 0.001). Further, there was a positive correlation between "brief-interventions" practices with the attitude of being "concerned and sympathetic" (p < 0.001). A mediation analysis revealed that nearly a third of the overall effect of the number of years of experience on brief-interventions practices was mediated by a concerned and sympathetic attitude. CONCLUSIONS Serious efforts must be made to train doctors in the effective management of SUD. Attitudes of the doctors influence practices such as brief interventions. Programs directed towards changing the attitudes of doctors can bring changes in their practices.
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Affiliation(s)
| | - Banavaram Anniappan Arvind
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - Bharath Holla
- Department of Integrative Medicine, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | | | - Arun Kandasamy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 56002, India
| | - Pratima Murthy
- Director and Senior Professor of Psychiatry,National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
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Murthy P, Shadakshari D, Mahadevan J, Chand PK. Management of Alcohol Use Disorder in Patients With Alcoholic Liver Disease. J Clin Exp Hepatol 2022; 12:1514-1526. [PMID: 36340303 PMCID: PMC9630026 DOI: 10.1016/j.jceh.2022.04.010] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/10/2022] [Indexed: 12/12/2022] Open
Abstract
Alcohol use disorder (AUD) is a common condition that develops on the background of heavy alcohol use and is characterised by the loss of control over alcohol use and a compulsion to use alcohol, often despite negative consequences. AUD is a leading cause for the resumption of alcohol use in patients with alcoholic liver disease (ALD) after treatment. Hence it is essential to screen all patients with ALD for the presence of AUD. Screening tools such as alcohol use disorders identification test (AUDIT) and AUDIT-C are used, following which the diagnosis and severity of AUD are determined using DSM-5 criteria. The management of AUD in patients with ALD is best carried out using an integrated approach involving psychiatrists and gastroenterologists/hepatologists. The treatment most often involves a combination of pharmacotherapy and psychosocial interventions which try to achieve and maintain abstinence. Although, there is limited evidence, Baclofen is the first line pharmacological agent for long-term management of AUD in patients with ALD. Intensive psychological interventions such as motivation enhancement therapy and cognitive behavioural therapy are also seen to be beneficial. Treatment retention and follow-up are vital and can positively influence outcomes.
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Key Words
- AA, Alcoholics Anonymous
- ALD, Alcoholic Liver Disease
- AMPA, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid
- AUD, Alcohol Use Disorder
- AUDIT – C, Alcohol Use Disorder Identification Test – Consumption
- AUDIT, Alcohol Use Disorder Identification Test
- CBT, Cognitive Behavioural Therapy
- CDT, Carbohydrate Deficient Transferrin
- CIWA – Ar, Clinical Institute Withdrawal Assessment for Alcohol Revised
- DALY, Disability Adjusted Life Years
- EtG, Ethyl glucuronide
- EtS, Ethyl Sulphate
- FAEE, Fatty acid ethyl ester
- FDA, Food and Drug Administration
- GABA, Gamma-Aminobutyric acid
- GGT, Gamma glutamyl transferase
- HCV, Hepatitis C Virus
- HE, Hepatic Encephalopathy
- LT, Liver Transplantation
- MCV, Mean corpuscular volume
- MET, Motivation Enhancement Therapy
- MI, Motivational Interviewing
- NMDA, N-Methyl-d-aspartate
- PEth, Phosphatidylethanol
- RCT, Randomised control trial
- SMS, Short Message Service
- alcohol use disorder
- alcoholic liver disease
- diagnosis
- pharmacotherapy
- psychotherapy
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Affiliation(s)
- Pratima Murthy
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Darshan Shadakshari
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Jayant Mahadevan
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Prabhat Kumar Chand
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
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Sukumaran SK, Paul P, Guttal V, Holla B, Vemula A, Bhatt H, Bisht P, Mathew K, Nadella RK, Varghese AM, K V, Purushottam M, Jain S, Sud R, Viswanath B, Viswanath B, Rao NP, Narayanaswamy JC, Sivakumar PT, Kandasamy A, Kesavan M, Mehta UM, Venkatasubramanian G, John JP, Purushottam M, Mukherjee O, Mehta B, Kandavel T, Binukumar B, Saini J, Jayarajan D, Shyamsundar A, Moirangthem S, Vijay Kumar KG, Mahadevan J, Holla B, Thirthalli J, Chandra PS, Gangadhar BN, Murthy P, Panicker MM, Bhalla US, Chattarji S, Benegal V, Varghese M, Reddy JYC, Padinjat R, Rao M, Jain S. Abnormalities in migration of neural precursor cells in familial bipolar disorder. Dis Model Mech 2022; 15:277960. [PMID: 36239094 PMCID: PMC9612872 DOI: 10.1242/dmm.049526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/22/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022] Open
Abstract
Cellular migration is a ubiquitous feature that brings brain cells into appropriate spatial relationships over time; and it helps in the formation of a functional brain. We studied the migration patterns of induced pluripotent stem cell-derived neural precursor cells (NPCs) from individuals with familial bipolar disorder (BD) in comparison with healthy controls. The BD patients also had morphological brain abnormalities evident on magnetic resonance imaging. Time-lapse analysis of migrating cells was performed, through which we were able to identify several parameters that were abnormal in cellular migration, including the speed and directionality of NPCs. We also performed transcriptomic analysis to probe the mechanisms behind the aberrant cellular phenotype identified. Our analysis showed the downregulation of a network of genes, centering on EGF/ERBB proteins. The present findings indicate that collective, systemic dysregulation may produce the aberrant cellular phenotype, which could contribute to the functional and structural changes in the brain reported for bipolar disorder. This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Salil K Sukumaran
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Pradip Paul
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vishwesha Guttal
- Centre for Ecological Sciences, Indian Institute of Science, Bangalore, India.,Centre for Biosystems and Bioengineering, Indian Institute of Science, Bangalore, India
| | - Bharath Holla
- Dept. of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Alekhya Vemula
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Harsimar Bhatt
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Piyush Bisht
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Kezia Mathew
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ravi K Nadella
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Anu Mary Varghese
- Dept. of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vijayalakshmi K
- Dept. of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Meera Purushottam
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sanjeev Jain
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Reeteka Sud
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Biju Viswanath
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Biju Viswanath
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Naren P Rao
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | | | - Arun Kandasamy
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | | | | | - John P John
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Meera Purushottam
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Odity Mukherjee
- Institute for Stem Cell Biology and Regenerative Medicine (InStem), India
| | - Bhupesh Mehta
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | - B Binukumar
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Jitender Saini
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Deepak Jayarajan
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - A Shyamsundar
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | - K G Vijay Kumar
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Jayant Mahadevan
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Bharath Holla
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | - Prabha S Chandra
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | - Pratima Murthy
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | | | - Sumantra Chattarji
- Institute for Stem Cell Biology and Regenerative Medicine (InStem), India
| | - Vivek Benegal
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Mathew Varghese
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | | | - Mahendra Rao
- Institute for Stem Cell Biology and Regenerative Medicine (InStem), India
| | - Sanjeev Jain
- National Institute of Mental Health and Neurosciences (NIMHANS), India
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K S, Nattala P, B A A, Murthy P. Nurses' perspectives regarding integrated nursing interventions for psychoactive substance use cessation: A mixed methods study from South India. Perspect Psychiatr Care 2022; 58:2183-2189. [PMID: 35133648 DOI: 10.1111/ppc.13045] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 01/16/2022] [Accepted: 01/29/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To obtain nurses' perspectives regarding integrated interventions for substance use cessation for patients in general hospital settings. DESIGN AND METHODS (a) Quantitative survey (N = 207) (nurses' knowledge, attitude, practice, confidence regarding integrated interventions; (b) Focus groups exploring nurses' perspectives regarding integrated interventions (N = 32). FINDINGS Participants' scores (mean, SD): Knowledge-112.5 (10.4) (maximum score-198); Attitude-30.99 (7.05) (maximum-52); Practice-1.66 (2.63) (maximum-28); Confidence-11.90 (3.82) (maximum-24). From the focus groups, four themes were identified: Substance use patterns among patients seeking treatment at the hospitals where the nurses are employed; Nurses' role in providing integrated interventions; Nurses' training needs for providing integrated interventions; Feasibility of providing integrated interventions. PRACTICE IMPLICATIONS Findings provide clear justification for module development to train nurses in providing integrated interventions.
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Affiliation(s)
- Sugavanaselvi K
- Department of Nursing, College of Nursing, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Prasanthi Nattala
- Department of Nursing, & Nursing Consultant, Center for Addiction Medicine, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Arvind B A
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Pratima Murthy
- Department of Psychiatry, Center for Addiction Medicine, & Director, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
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Nedungottil C, Agrawal J, Sharma MP, Murthy P. Men with and without Alcohol Dependence: A Comparative Study of Triguna, Nonattachment, Personality and Subjective Well-Being. Int J Yoga 2022; 15:222-229. [PMID: 36949831 PMCID: PMC10026343 DOI: 10.4103/ijoy.ijoy_128_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/17/2022] [Accepted: 11/23/2022] [Indexed: 01/18/2023] Open
Abstract
Context Indian models of personality are seldom explored in relation to alcohol dependence. Triguna is an Indian model of personality originating from the Sankhya philosophy, whereby three gunas, Sattva, Rajas and Tamas describe personality features. Additionally, the trait of Non attachment which is a concept discussed extensively in Bhagavad Gita is also studied along with Triguna. Aims The current study discusses these concepts and attempts to explore their relationship with personality and subjective well-being, among men with and without alcohol dependence. Subjects and Methods A cross-sectional survey method was adopted, with a sample of 84 men from the community without alcohol dependence, screened through alcohol use disorders identification test and 30 men diagnosed with alcohol dependence. Informed consent was obtained from all the participants. Statistical Analysis Used The data were analyzed using descriptive statistics, independent sample t-test, and Mann-Whitney U-test. Results Men without alcohol dependence scored significantly higher on variables such as Sattva, extraversion and conscientiousness, positive affect, and life satisfaction, than men in the clinical group. Men who were diagnosed with alcohol dependence, scored significantly higher on Tamas, neuroticism, and negative affect. Conclusions This novel understanding of the personality structure of patients with alcohol dependence from the Triguna perspective may be helpful in the development of indigenous psychological interventions for alcohol dependence.
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Affiliation(s)
- Chandana Nedungottil
- Department of Psychiatry, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Jyotsna Agrawal
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mahendra Prakash Sharma
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Nattala P, Kishore MT, Murthy P, Christopher R, Veerabathini JS, Suresh S. Association between Parent-Reported Executive Functions and Self-Reported Emotional Problems among Adolescent Offspring of Fathers with Alcohol-Dependence. J Neurosci Rural Pract 2022; 13:441-447. [PMID: 35946027 PMCID: PMC9357492 DOI: 10.1055/s-0042-1745820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives
To compare the executive functions in adolescents of fathers with alcohol dependence (AOFADs) with a control group of adolescents without a paternal history of alcohol dependence and examine the association between executive functioning problems and behavioral and emotional problems.
Materials and Methods
The study included 39 AOFADs and 45 adolescent offspring of fathers without a history of alcohol-use disorders, who were matched for age and sex. They were assessed using standardized measures of executive functions and emotional and behavioral problems.
Statistical Analysis
A comparison was made between the two groups about the parental report of adolescents' executive functions and adolescents' self-reported emotional and behavioral problems. ANCOVA was performed to understand the covariance of educational and socio-economic status on executive functions. Correlation between executive functions, emotional and behavioral problems, and the duration of father's alcohol dependence was examined with Spearman's rho.
Results
AOFAD group showed significant impairment on all subdomains of executive functions and emotional and behavioral disturbances (
p
< 0.01) but not on the prosocial behavioral dimension (
p
< 0.01). The group differences were independent of child's education and family income. Executive functional impairments positively correlated with psychopathology (
p
< 0.01). Problems with executive functions and psychopathology correlated with the duration of the father's alcohol dependence.
Conclusions
AOFADs are at risk for executive function impairments which in turn are strongly associated with emotional and behavioral problems. The association is independent of child's education and family economic status. The duration of alcohol dependence in fathers is associated with these problems. It has implications for targeted interventions for both adolescents and families.
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Affiliation(s)
- Prasanthi Nattala
- Department of Nursing, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - M. Thomas Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Rita Christopher
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Jessy Sharon Veerabathini
- Department of Nursing, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sumegha Suresh
- Department of Nursing, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Abstract
PURPOSE OF THE REVIEW The prevalence of mental and substance use disorders is three to five times higher than that of the general population. Psychosocial interventions are effective in identifying and managing mental health and substance use disorders. This article aims to review the randomized control studies which have used nonpharmacological interventions alone or in combination with pharmacological interventions for managing mental and substance use disorders in prison/correctional settings. COLLECTION AND ANALYSIS OF DATA Studies included were randomized control trials and pilot randomized studies that assessed the impact of psychosocial interventions for prisoners with mental disorders and substance use disorders. A comprehensive search for articles was done by the primary author (Sreekanth Nair Thekkumkara) in the following databases: PubMed, ProQuest, PsychArticles, and Google Scholar (search engine), for the period June 1, 2000, to December 31, 2020. RESULTS AND CONCLUSIONS The 21 studies included in the review had a sample size of 34 to 759. The settings of all the interventions were the prison and different types of psychosocial interventions were provided across the studies. The average duration of intervention ranged between 10 min and 120 min with the frequency of one to six sessions per week for 1 to 36 months. All the 21 Randomized Control Trials (RCTs) were nonIndian studies. Overall, the results of the included studies showed significant improvement postintervention (motivational intervention, interpersonal therapy, cognitive behavior therapy, positive psychology intervention, music therapy, and acceptance and commitment therapy) on primary outcome measures such as symptom severity of depression, anxiety, and substance abuse prisoners. Positive effects were observed on secondary outcome measures such as motivation, aggression, follow up rates, and recidivism. A limited number of studies have focused on evaluating psychosocial interventions in prison settings. Most of the interventions were tested in prisoners with substance use disorder alone or in those with dual diagnoses and in high-income countries.
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Affiliation(s)
- Sreekanth Nair Thekkumkara
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Aarti Jagannathan
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Krishna Prasad Muliyala
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pratima Murthy
- Professor of Psychiatry, Director National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Mukherjee D, Narasimha VL, Shukla L, Mahadevan J, Murthy P, Benegal V. How Do Individuals with Alcohol Use Disorders Think About and Respond to Election Dry Days? Indian J Psychol Med 2022; 44:313-315. [PMID: 35656433 PMCID: PMC9125467 DOI: 10.1177/02537176211013497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Diptadhi Mukherjee
- Centre for Addiction Medicine, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | | | - Lekhansh Shukla
- Centre for Addiction Medicine, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Jayant Mahadevan
- Centre for Addiction Medicine, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | | | - Vivek Benegal
- Dept. of Psychiatry, AIIMS, Deoghar, Jharkhand, India
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Thekkumkara SN, Jagannathan A, Muliyala KP, Murthy P. Development and validation of a peer support programme for the prisoners with mental and substance use disorders in India. Indian J Psychiatry 2022; 64:316-321. [PMID: 35859557 PMCID: PMC9290426 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_416_21] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 01/06/2022] [Accepted: 03/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of mental health problems and substance use disorders is high in prisons. There is a need to develop effective and sustainable models in prison to address their mental health demands. AIM The study aimed to develop and validate a peer support programme (PSP) for prisoners with common mental and substance use disorders (SUD). METHOD The PSP was developed by reviewing the literature and expert interviews and validated by seven experts. RESULT The expert interview brought out a total of 10 themes. The final components included in the content of the peer support interventions were information about mental health issues, identification of the cases, basic counseling skills, psycho-education, early warning signs and symptoms, managing substance use by motivational interviewing, and suicidal gatekeeping. CONCLUSION This study describes the development of a comprehensive PSP, and it needs to be tested to examine its feasibility and effectiveness in addressing mental health problems in prison settings.
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Affiliation(s)
| | - Aarti Jagannathan
- Department of Psychiatric Social Work, NIMHANS, Bengaluru, Karnataka, India
| | | | - Pratima Murthy
- Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
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Rajalu BM, Indira Devi B, Shukla DP, Shukla L, Jayan M, Prasad K, Jayarajan D, Kandasamy A, Murthy P. Traumatic brain injury during COVID-19 pandemic-time-series analysis of a natural experiment. BMJ Open 2022; 12:e052639. [PMID: 35396279 PMCID: PMC8995573 DOI: 10.1136/bmjopen-2021-052639] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This study aims to find if the incidence and pattern of traumatic brain injury (TBI) changed during the COVID-19pandemic. We also aim to build an explanatory model for change in TBI incidence using Google community mobility and alcohol sales data. DESIGN A retrospective time-series analysis. SETTING Emergency department of a tertiary level hospital located in a metropolitan city of southern India. This centre is dedicated to neurological, neurosurgical and psychiatric care. PARTICIPANTS Daily counts of TBI patients seen between 1 December 2019 and 3 January 2021 (400 days); n=8893. To compare the profile of TBI cases seen before and during the pandemic, a subset of these cases seen between 1 December 2019 and 31 July 2020 (244 days), n=5259, are studied in detail. RESULTS An optimal changepoint is detected on 20 March 2020 following which the mean number of TBI cases seen every day has decreased and variance has increased (mean 1=29.4, variance 1=50.1; mean 2=19.5, variance 2=59.7, loglikelihood ratio test: χ2=130, df=1, p<0.001). Two principal components of community mobility, alcohol sales and weekday explain the change in the number of TBI cases (pseudo R2=58.1). A significant decrease in traffic accidents, falls, mild/moderate injuries and, an increase in assault and severe injuries is seen during the pandemic period. CONCLUSIONS Decongestion of roads and regulation of alcohol sales can decrease TBI occurrence substantially. An increase in violent trauma during lockdown needs further research in the light of domestic violence. Acute care facilities for TBI should be maintained even during a strict lockdown as the proportion of severe TBI requiring admission increases.
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Affiliation(s)
- Banu Manickam Rajalu
- Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Bhagavatula Indira Devi
- Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India
- Collaborator in National Institute for Health Research Global Health Research Group on Neurotrauma (NIHRGHRGNT), National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Dhaval P Shukla
- Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Lekhansh Shukla
- Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Mini Jayan
- Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Krishna Prasad
- Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Deepak Jayarajan
- Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arun Kandasamy
- Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Pratima Murthy
- Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
- Director, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Nattala P, Doraiswamy P, Murthy P. Development and pilot-testing of a skill-based intervention to prevent psychoactive substance use among college students: A study from Bangalore, India. J Family Med Prim Care 2022; 11:3600-3606. [DOI: 10.4103/jfmpc.jfmpc_2488_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 11/04/2022] Open
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46
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Rajan S, Paton LW, Chowdhury AH, Zavala GA, Aslam F, Huque R, Khalid H, Murthy P, Nizami AT, Prasad Muliyala K, Shiers D, Siddiqi N, Boehnke JR. Knowledge and Response to the COVID-19 Pandemic in People With Severe Mental Illness in Bangladesh and Pakistan: A Cross-Sectional Survey. Front Psychiatry 2022; 13:785059. [PMID: 35237185 PMCID: PMC8884107 DOI: 10.3389/fpsyt.2022.785059] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/12/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND People with severe mental illnesses (SMIs) are likely to face disproportionate challenges during a pandemic. They may not receive or be able to respond to public health messages to prevent infection or to limit its spread. Additionally, they may be more severely affected, particularly in low- and middle-income countries. METHODS We conducted a telephone survey (May-June 2020) in a sample of 1,299 people with SMI who had attended national mental health institutes in Bangladesh and Pakistan before the pandemic. We collected information on top worries, socioeconomic impact of the pandemic, knowledge of COVID-19 (symptoms, prevention), and prevention-related practices (social distancing, hygiene). We explored the predictive value of socio-demographic and health-related variables for relative levels of COVID-19 knowledge and practice using regularized logistic regression models. FINDINGS Mass media were the major source of information about COVID-19. Finances, employment, and physical health were the most frequently mentioned concerns. Overall, participants reported good knowledge and following advice. In Bangladesh, being female and higher levels of health-related quality of life (HRQoL) predicted poor and better knowledge, respectively, while in Pakistan being female predicted better knowledge. Receiving information from television predicted better knowledge in both countries. In Bangladesh, being female, accessing information from multiple media sources, and better HRQoL predicted better practice. In Pakistan, poorer knowledge of COVID-19 prevention measures predicted poorer practice. CONCLUSION Our paper adds to the literature on people living with SMIs and their knowledge and practices relevant to COVID-19 prevention. Our results emphasize the importance of access to mass and social media for the dissemination of advice and that the likely gendered uptake of both knowledge and practice requires further attention.
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Affiliation(s)
- Sukanya Rajan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Lewis W Paton
- Department of Health Sciences, University of York, York, United Kingdom
| | | | - Gerardo A Zavala
- Department of Health Sciences, University of York, York, United Kingdom
| | - Faiza Aslam
- Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, Pakistan
| | | | - Humaira Khalid
- Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, Pakistan
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Asad T Nizami
- Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, Pakistan
| | - Krishna Prasad Muliyala
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - David Shiers
- Greater Manchester Mental Health National Health Service Trust, Trust Headquarters, Manchester, United Kingdom.,Division of Psychology and Mental Health, The University of Manchester, Manchester, United Kingdom.,Primary Care and Health Sciences, Keele University, Newcastle, United Kingdom
| | - Najma Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom.,Hull York Medical School, York, United Kingdom.,Bradford District Care National Health Service Foundation Trust, Shipley, United Kingdom
| | - Jan R Boehnke
- Department of Health Sciences, University of York, York, United Kingdom.,School of Health Sciences, University of Dundee, Dundee, United Kingdom
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Khadse PA, Ghosh S, Murthy P, Girimaji SC. Student Suicides in the Context of Online Education During COVID-19 Pandemic in India: Analysis of Media Reports. Indian J Psychol Med 2022; 44:91-94. [PMID: 35509658 PMCID: PMC9022916 DOI: 10.1177/02537176211061224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Pawan Arun Khadse
- Centre for Addiction Medicine, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Sreyoshi Ghosh
- Dept. of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Pratima Murthy
- Centre for Addiction Medicine, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Satish C Girimaji
- Dept. of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Ezhumalai S, Muralidhar D, Murthy P. Occupational factors associated with long-term abstinence among persons treated for alcohol dependence: A follow-up study. Indian J Occup Environ Med 2022; 26:122-128. [PMID: 35991207 PMCID: PMC9384881 DOI: 10.4103/ijoem.ijoem_37_22] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/05/2022] [Accepted: 03/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background Several studies have examined the occupational factors associated with alcohol use and dependence. However, there are very few studies that investigated the role of occupational factors associated with long-term abstinence among persons treated for alcohol dependence in India. Aim To examine the occupational factors associated with long-term abstinence among persons treated for alcohol dependence. Methods Sixty in-patients treated for alcohol dependence were selected using inclusion criteria from the Government-run de-addiction center, tertiary care teaching hospital, Bangalore. All patients were followed up periodically for 1 year. The semi-structured interview schedule was used for collecting data on occupational factors associated with long-term abstinence. Descriptive statistics, Chi-square test, and Fisher exact test were used for data analysis. Results There was a positive trend showing self-employed (pf = 1.74, P = 0.45), having skilled work (pf = 1.52, P = 0.72), regular pattern of employment (pf = 1.21, P =.60), monthly mode of income (pf = 1.43, P =.76) were factors associated with abstinence. Among eight occupational variables, employment status (x 2 = 4.0, P =.04) and having well-defined working hours ((pf = 6.18, P =.04) were significantly associated with long-term abstinence among persons treated for alcohol dependence. Conclusion Occupational factors seem to influence the outcome in alcohol dependence and appropriate vocational interventions would be effective in promoting long-term abstinence.
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Affiliation(s)
- Sinu Ezhumalai
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India,Address for correspondence: Dr. Sinu Ezhumalai, Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangaluru - 560029, Karnataka, India. E-mail:
| | - D. Muralidhar
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Chandran S, Sreeraj VS, Venkatasubramanian G, Sathyaprabha TN, Murthy P. Corpus callosum morphometry in children with prenatal alcohol exposure. Psychiatry Res Neuroimaging 2021; 318:111405. [PMID: 34743066 DOI: 10.1016/j.pscychresns.2021.111405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022]
Abstract
Alcohol is known to have a neurotoxic effect on the brain of offspring of mothers consuming alcohol during pregnancy. Impact on the neurodevelopment in children who were exposed to alcohol specifically during the antenatal period without any clinically detectable features of fetal alcohol syndrome is less well studied. In this cross-sectional study, structural magnetic resonance imaging (MRI) of the brain was acquired in 28 children whose mothers had consumed alcohol during pregnancy and 30 children of mothers who did not consume alcohol during pregnancy. Areas of Corpus callosum (CC) and its parts in the mid-sagittal section were calculated using morphometric analysis of MRI through Witelson's method. Midbody of CC was found to be significantly smaller in children exposed to alcohol during the prenatal period. CC is a sensitive white matter structure to neurotoxic effects of alcohol during prenatal life. This impact could be visible in developmental age even in those without any clinically detectable features of alcohol exposure.
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Affiliation(s)
- Sajish Chandran
- Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), 560061 Bengaluru India
| | - Vanteemar S Sreeraj
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru India
| | - Talakad N Sathyaprabha
- Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), 560061 Bengaluru India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru India.
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Nattala P, Meena KS, Murthy P, Rao GN, Rajani P, Doraiswamy P. Screening and Health Education Services by Accredited Social Health Activists Regarding Impact of Psychoactive Substance Use and Self-Medication During Pregnancy and Lactation, at Government Health Centres in Bangalore, India. Indian J Community Med 2021; 46:566-567. [PMID: 34759513 PMCID: PMC8575218 DOI: 10.4103/ijcm.ijcm_800_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 08/02/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Prasanthi Nattala
- Department of Nursing, 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
| | - Pratima Murthy
- Department of Psychiatry, Center for Addiction Medicine, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Girish N Rao
- Department of Epidemiology, Center for Public Health, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | | | - Padmavathy Doraiswamy
- Department of Nursing, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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