Indian Journal of Behavioural Sciences

Neurocognitive Impairment in Opioid Dependence Syndrome

2024-01-25T06:05:47+00:00

Substance use is a chronic condition characterized by remissions and relapses.1 Substance use disorder, commonly referred to as addiction, is a complex and chronic medical condition characterized by the harmful or hazardous use of substances. It affects the brain and behavior, leading to an inability to control one’s use of these substances despite the negative consequences.

Platelet to Lymphocyte Ratio and Monocyte to Lymphocyte Ratio in Depression: A Case-Control Study

2024-01-24T15:53:36+00:00

Introduction: Platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) are cheap and readily available blood parameters that are markers of inflammation and bear the potential to serve as biomarkers for depression.
Aims: The primary objective of this study was to compare PLR and MLR in patients of unipolar depression with healthy controls. The secondary objectives of this study were to analyze the correlation of PLR and MLR with the severity of depression at baseline and to assess the change in PLR and MLR in patients with depression after treatment.
Subjects and methods: Consenting drug-free patients of unipolar depression were included as cases if they were aged > 18 years, any gender, and were free of other psychiatric disorders, substance dependence except caffeine/nicotine, major medical/hematological illness/infection, pregnancy, or lactation. Age and sex-matched healthy adults were recruited as controls with consent. All the participants were assessed at baseline, and cases were reassessed after at least six weeks of treatment.
Results: The PLR was significantly higher (p-value = 0.002) among the cases (median: 124.51, IQR:63.17) than the controls (median: 99.50, IQR:47.85), at baseline before starting treatment. The area under the curve for the receiver operating characteristic curve for PLR values at baseline was 0.633. The MLR did not differ significantly between the two groups. There was no change in PLR or MLR in cases after treatment. The PLR and MLR values did not correlate with the severity of depression at baseline.
Conclusion: PLR, not MLR, could be a potential trait marker for depression. Further studies are warranted

Assessment of the Efficacy of Intensive Continuous Theta Burst Stimulation over Supplementary Motor Area in Psychogenic Non-Epileptic Seizure: A Randomized Sham-Controlled Pilot Trial

2023-11-29T09:57:49+00:00

Objectives: There is a need for novel treatment strategies for psychogenic non-epileptic seizures (PNES). Thus, we aimed to evaluate the effectiveness of continuous theta burst stimulation (cTBS) over supplementary motor area (SMA) in PNES using a randomized, sham-controlled design.
Material and Methods: About 20 right-handed patients aged between 18 to 59 years were randomly allocated into active and sham groups to receive cTBS sessions (2 sessions /day, half an hour apart, 1200 pulses per day, at 80% MT) for 5 days in a week over SMA. PNES patients were evaluated on the psychogenic non-epileptic seizure scale (PNSS), dissociative experiences scale (DES-II), hospital anxiety depression scale (HADS), WHOQOL-BREF, and clinical global impression-severity (CGI-S) at baseline, after 10th rTMS session, and2-weeks post cTBS.
Results: Our study fails to show a significant effect on between group* time interaction in the frequency of PNES attacks (F = 0.011; p = 0.998), total-PSS (F = 0.429; p = 0.654), DES-II (F = 1.865; p = 0.169), CGI-S (F = 0.239; p = 0.789)in an intention to treat protocol across 3 weeks. Minimal side effects were reported and no patient discontinued the trial citing side effects.
Conclusion: We conclude that intensive SMA, cTBS in PNES is well tolerated with non-inferior clinical benefits when compared to placebo

Prevalence of Parasomnias and Restless Leg Syndrome in Patients taking Psychotropic Medications (Antidepressants and Antipsychotics): A Cross-Sectional Hospital-based Study

2023-12-01T07:16:58+00:00

Introduction: Parasomnias and restless leg syndrome (RLS) have often been linked to antidepressant and antipsychotic drug use. Most of the information in this area is available in the form of case reports and systematic studies comparing both these disorders across various antidepressants and antipsychotic medication is limited.
Aim: To compare the prevalence of RLS and different parameters of parasomnias among various classes of psychotropics (antidepressants and antipsychotic medication).
Methods: A total of 112 subjects between the age of 18 to 60 years participated in this study and were selected by convenient sampling method based on the inclusion and exclusion criteria. Subjects were divided into two groups one which had been prescribed selective serotonin reuptake inhibitor (SSRI) and another group was prescribed non-SSRI (which includes SNRI, TCA, NaSSA and antipsychotics) for the past three months and above in adequate dose. Subjects were diagnosed as having RLS as per DSM 5 criteria and parasomnias was assessed using the Munich parasomnia screening questionnaire. Data was tabulated and appropriate statistics were applied.
Results: About 24.1% of the study subjects had RLS. Most of the patients on SSRI (80.4%) and non-SSRI (72.1%) did not have RLS which was statistically significant while proportion wise higher number of patients in the non-SSRI group had RLS (27.9%) as compared to the SSRI group (19.6%). On estimating parasomnias, we found that 82.1% of the subjects had rhythmic foot movement followed by nocturnal leg cramps (33.9%). Various types of parasomnias were higher in the non-SSRI group as compared to the SSRI group which was statistically significant (p < 0.05).
Conclusion: Most of the subjects on SSRI and non-SSRI drugs did not have RLS but proportion-wise non-SSRI drugs have higher odds of causing RLS as compared to SSRI. Also, non-SSRI drugs have a higher probability of causing various types of parasomnias

Neutrophil and Plasma Nitrite Levels and Neuronal Nitric Oxide Synthase Expression in Schizophrenia: A Case-Control Study

2023-12-01T07:20:18+00:00

Background: In neural tissues, neuronal nitric oxide synthase (nNOS) primarily leads to nitric oxide (NO) synthesis which acts as a neurotransmitter. NO is also an oxidant produced during oxidative stress states and has been implicated in the etiopathogenesis of schizophrenia. Thus, it can be a potential biomarker of schizophrenia.
Aims: In this study, we aimed to determine the differences in the levels of nNOS (in circulating neutrophil) and nitrite (in circulating neutrophil and plasma) in the drug naïve or drug-free patients of first-episode schizophrenia, their first-degree relatives (FDR) and healthy controls (HC).
Methods: Drug-free adults with schizophrenia, and age and sex-matched FDRs, and HCs were tested for nNOS expression (in circulating neutrophil) and nitrite levels (in circulating neutrophil and plasma). Kruskal Wallis H test was used to compare continuous variables.
Results: The final sample consisted of 31 participants in each group. The nNOS expression was significantly higher in schizophrenia patients compared to FDRs and HCs. In patients the plasma and neutrophil nitrite levels were significantly lower compared to HCs, but not FDRs. The nNOS expression among FDRs was also significantly higher compared to HCs. There was no correlation among nNOS expression, plasma nitrite level, and neutrophil nitrite level.
Conclusions: Plasma and neutrophil nitrite could be potential trait markers for schizophrenia. There is no straightforward association between nNOS expression, and nitrite levels in plasma and circulating neutrophils.

Internet Addiction Among Nursing Students

2023-06-22T10:11:59+00:00

Introduction: The Internet is incorporated as a part of the day-to-day life of every individual irrespective of their age as its usage has been growing explosively worldwide. It has dramatically changed the current information and communication scenario, and there has been an explosive increase in Internet users worldwide in the last decade. As behavioral addiction, Internet addiction leads to symptoms traditionally associated with substance-related addictions namely salience, tolerance, withdrawal, conflict, and relapse. The objectives of the study were to assess the level of internet addiction among nursing students and to determine the association between internet addiction and socio-demographic variables.
Methods: A quantitative approach with a descriptive design was used for the study. The setting chosen for the present study was Sree Gokulam Nursing College, Venjaramoodu, Kerala. The sample consisted of undergraduate nursing students who satisfied the inclusion criteria and were selected by simple random sampling. The sample size for the study was 185. The tools used for data collection were socio-personal proforma and the internet addiction scale by Dr. Kimberly Young, which categorizes internet users to normal internet users (0–20), mild internet addiction (21–49), moderate internet addiction (50–79) and severe internet addiction (80–100).
Results: The majority of subjects (91.9%) were females, single (95.7%) and the majority (48%) were under the age group of 19 to 20 years. Nearly half (47.6%) of the study subjects have internet access at their home. Among those 53.0% of subjects used Facebook as their most preferable site. The majority of the subjects were found to have normal internet usage (67.0%) and mild internet addiction 31%. The mean score of internet addiction was 15.13 and standard deviation was 1.27. There was no significant association between internet addiction and socio-demographic variables.
Conclusion: As the study finding indicates with the increased use of the internet in today’s society, there is a potential for overuse of technology and neglect of others and self as a result of internet addiction. Nowadays internet addiction is an increasingly recognized condition and one in which nurses can play a key role in management

Perceived Stress, Depression, Anxiety, and Stress Among Frontline Healthcare Workers Working in COVID-19 Level 2 Hospital

2023-11-29T10:22:55+00:00

Background: The COVID-19 pandemic had the potential to significantly affect the mental health of healthcare workers (HCWs), who stood on the frontline of this crisis. The study determines the level of perceived stress, anxiety, depression, and stress among healthcare workers during the first phase of COVID-19.
Subjects and Methods: A cross-sectional descriptive study was done among the healthcare workers (Non-PG Junior residents, interns, and nursing staff) working in the COVID level-2 hospital from May 10, 2020, to July 30, 2020. DASS-21 scale was used to determine the level of depression, anxiety, stress, and perceived stress was measured by the perceived stress scale (PSS). The statistical analysis was done with GraphPad instat version 3.06. The scores of DASS and PSS were compared using the Kruskal-Wallis test.
Results: It was seen that overall prevalence of depression was 36.84% among all the groups of HCW with 10.6% having mild and 16.20% having moderate depression. The prevalence of anxiety and stress in participants was 39.8 and 41.73%, respectively. The prevalence of perceived stress level was found to be 86% with the majority (64.80%) having mild perceived stress level. No significant difference was observed among the different HCW groups regarding stress, anxiety, depression, and perceived stress. It was observed that participants having high perceived stress levels were more depressed (p < 0.0001), more anxious (p < 0.0001) and more stressed (p < 0.0001).
Conclusion: HCWs experienced stress, anxiety, and depression during the COVID-19 pandemic. HCWs with higher perceived stress were more depressed, anxious, and more stressed.

Relationship of Behavioral and Cognitive Abilities in Subjects with Pathological Dissociation: An Exploratory Study

2023-11-29T10:26:29+00:00

Dissociation is a disruption in the coordinated functioning of consciousness, memory, identity, emotion, perception, motor control, and behavior. We aimed to investigate the phenomenon of dissociation and its relationship with neuro-cognitive processes. A cross-sectional study involving adult participants from a Tertiary Neuropsychiatry Center was divided into two groups based on dissociative experience scale (DES) scores followed by mindfulness attention awareness scale (MAAS), and a battery of neuropsychological tests to measure attention, concentration, memory, and other executive functions. Nine participants (22.2% females) with a mean age of 28.2 ± 7.5 years were grouped into extreme pathological dissociation (N = 4), and mild dissociation (N = 5). The total DES scores were significantly higher in subjects with extreme pathological dissociation (24.46 ± 7.3) as compared to those with mild dissociation (9.93 ± 2.58). The Stroop effect [160.4 ± 49 (p = 0.05)] and digit vigilance errors (16 ± 11.1 (p = 0.019) were significantly higher in the mild dissociation group. Further research is required to understand the presence of altered information processing speed and attention in mild dissociation

Assessment of Behavioral and Psychological Symptoms in Dementia, Associated Risk Factors and Clinical Correlates

2023-11-29T10:18:57+00:00

Background: The presence of behavioral and psychological symptoms in dementia (BPSD) are associated with hospitalization, rapid cognitive decline, poor quality of life and higher caregiver burden. Thus, we aim to characterize the BPSD symptoms, its relationship to dementia-related risk factors and their predictive value, if any.
Methodology: In 48 adults (mean age: 70.27 ± 10.08) with major neurocognitive disorder (MNCD) as per diagnostic and statistical manual of mental disorders, 5th edition and with Hindi mental status examination scores less than or equal to 23 were recruited. Patients were assessed for cognition by hindi Montreal cognitive assessment (HMOCA) and the clinical dementia rating scale (CDR). BPSD and caregiver burden were assessed using the neuropsychiatric inventory (NPI) and burden assessment schedule (BAS). The correlation of NPI scores with socio-demographic variables and clinical variables was assessed. A forward stepwise linear regression (using p-value < .05) was used to identify possible predictors of the NPI scores.
Results: The majority of participants were predominantly males, 25 (52.1%), from urban regions, belonged to middle-class socio-economic status and had severe grading (HMOCA (< 10) of MNCD (25 (52.2%) but had moderate caregiver burden (25 (52.2%)). The most common MNCD type was due to Alzheimer’s disease (22 (45.8%)). Cortical atrophy and ischemic infarcts were the most common neuroimaging abnormalities reported (7 (14.9%)). Mean HMOCA, clinical dementia rating scale (CDR), NPI and BAS scores were 9.13 ± 6.96, 1.50 ± 1.05, 41.79 ± 27.06 and 68.65 ± 22.84, respectively. The most common BPSD domains were sleep disturbance (60.4%) and hallucinations (56.25%). Among the established risk factors, hypertension was present in the highest proportion (21 (43.8%)). As per the stepwise logistic regression model CDR scores, smoking status and HTN were predicted risk factors (R²: 0.452; p = 0.045).
Conclusion: Irritability/agitation is most prevalent BPSD. The severity of MNCD, smoking and hypertension may help in the prediction of BPSD and their role may have to be explored in further studies.

Compassion Fatigue Amongst Resident Doctors of a Medical College

2024-03-23T04:55:44+00:00

Background: The healthcare sector demands tireless commitment and resident doctors go through intensive clinical training with long working hours and emotionally charged patient interactions. This might lead to emotional exhaustion, reduced empathy, and a sense of diminished personal accomplishment, all of which is a part of the complex psychological condition of compassion fatigue, which can profoundly impact the well-being of healthcare professionals. Compassion fatigue is a term given to the secondary stress suffered by those in helping professions who are working with those suffering from trauma.
Objectives: (1) To assess the prevalence of compassion fatigue in resident doctors. (2) To find out the association between compassion fatigue and work-related factors among resident doctors.
Methods: The present cross-sectional study was done among the doctors in the Tertiary Care Centre of district Meerut. Data was collected from 200 residents of different departments and medical specialities using a questionnaire consisting of professional quality of life scale along with information regarding sociodemographic and work-related factors.
Result: A higher level of compassion satisfaction was seen in those who had more years of practice. Residents with excessive number of work hours and predominantly overnight shifts appear to be at higher risk of developing compassion fatigue related to higher burnout and secondary traumatic stress.
Conclusion: The assessment of compassion fatigue among resident doctors highlights the impact of working conditions on their well-being. Addressing factors like long working hours, high patient loads, and lack of support from administration will help reduce compassion fatigue among the resident doctors.

The Prevalence and Determinants of Internet Addiction in Medical Students at a Government Medical College in Uttar Pradesh, India

2024-03-01T07:15:43+00:00

Introduction: The issue of Internet addiction is rampant amongst medical students as they are vulnerable due to personal, social and academic pressure. It is plausible to foresee a future where this seemingly harmless pastime leads to dire consequences on the mental as well as physical well-being of students.
Objectives: This study aims to find out the prevalence of internet addiction among undergraduate students. The study also aims to figure out various determinants and factors that are associated with addiction, such as gender differences, the professional year of the medical student and the main purpose of internet use.
Methods: A study was conducted at LLRM Medical College, Meerut, and it included 354 students selected by simple random sampling. They filled out a questionnaire with the first part regarding socio-demographic details and the second part of it is Young’s internet addiction test. According to the score, the students were categorized into normal users (<30), mild addiction (30–50), moderate addiction (50–80) and severe addiction (80–100).
Results and discussion: Out of 354 students, 31.63% are mildly addicted, 33.05% are moderately addicted and 3.96% are severely addicted. The remaining 31.35% comprises the normal users. Therefore, a total of 68.64% of students are addicted. The factors associated with a higher risk of addiction are found to be male gender, using social media and first year of college.
Conclusion: The increasing prevalence of internet addiction should prove eye-opening for medical students to make better use of their free time by doing productive activities. They must keep an active check regarding their daily screen time.

Unraveling the Link Between Prolonged Sitting, Sedentary Lifestyle and Mental Health

2024-03-23T04:52:04+00:00

Health professionals in general and mental health professionals, in particular, should be aware of the impact of prolonged sitting and sedentary lifestyles on health and mental health. In current society, a large percentage of the population is engaged in employment or practices a lifestyle that requires prolonged sitting during the day and a sedentary lifestyle. In fact, sedentary behaviors are very common in daily life.

Psychedelic Drugs: A Mind-expanding Hallucinogens

2024-02-22T07:05:20+00:00

Psychedelics are mainly from the class of psychoactive substances whose action is to produce changes in the perception, mood, cognitive behavior, and processes of a person. This psychedelic drug creates an alteration in a person’s thinking, sense of time, and emotions. Hallucinations can be a main cause for people who take psychedelics. Mainly, these psychedelic drugs have been used since ancient times. The most famous psychedelics that were used abundantly were magic mushrooms, mescaline, and DMT, which people used for smoking, swallowing, or inhaling. Mushrooms were usually eaten fresh, cooked, or mixed with tea. Occasionally, people of the ancient period used to take it with tobacco or cannabis. The common forms of NBOMe are inactive when swallowed; the most common methods of taking them are under the tongue, held on the cheek, or snorted. Some types of psychedelic drugs, such as psilocybin and MDMA (ecstasy), have helped in therapies for treatment-resistant depression and post-traumatic stress disorder