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BACKGROUND: First-rank symptoms (FRS) in schizophrenia have been found to be associated with various cognitive and biological markers. Repetitive transcranial magnetic stimulation (rTMS) has been shown to modulate such factors. We hypothesized that rTMS adjunctive to antipsychotics will be safe and effective in treatment of FRS in schizophrenia. METHODS: Schizophrenia patients with FRS randomly received either active or sham-magnetic resonance imaging navigated continuous Θ burst stimulation (cTBS)-rTMS to right inferior parietal lobule for 2 weeks; assessments were repeated. While primary outcome variables were safety profile, FRS and overall psychopathology; secondary outcomes were γ oscillatory activity, brain-derived neurotrophic factor levels, and self-monitoring function. RESULTS: No significant adverse events were reported in either group. None of the outcome measures showed sufficient power on the time by group analysis. CONCLUSIONS: This study fails to demonstrate whether or not adjunctive cTBS to right inferior parietal lobule could significantly alleviate FRS. We also fail to provide evidence for whether this protocol has any effect on brain-derived neurotrophic factor levels, self-monitoring function, and right hemispheric γ oscillations. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved Source

Kumar A.,Sanjay Gandhi Post Graduate Institute of Medical Sciences | Khess C.R.J.,Central Institute of Psychiatry
Indian Journal of Psychiatry

Background: Controversy persists with regard to how best we can categorize symptomatic dimension of Schizophrenia. Aim of the study was to compute factorial dimensions in Indian subset of schizophrenic patients and to compare them with five factor pentagonal model extracted in western studies. Materials and Methods: 150 inpatients of Schizophrenia with acute exacerbation were subjected to PANSS rating within one week of admission and statistical calculation done based on exploratory factor analysis. Results: Five factors namely negative, autistic, activation, positive and depression were extracted wherein negative factors showed highest percentage of total variance supporting five factor modal of western literature Conclusion: A consensus is gradually emerging regarding symptomatic dimensions of Schizophrenia. Source

Sahoo S.,National Institute of Mental Health and Neuro Sciences | Khess C.R.J.,Central Institute of Psychiatry
Journal of Nervous and Mental Disease

The lifetime prevalence of depression, anxiety, and stress among adolescents and young adults around the world is currently estimated to range from 5% to 70%, with an Indian study reporting no depression among college going adolescents. This cross-sectional study was conducted to determine prevalence of current depressive, anxiety, and stress-related symptoms on a Dimensional and Categorical basis among young adults in Ranchi city of India. A stratified sample of 500 students was selected to be representative of the city's college going population (n = 50,000) of which 405 were taken up for final analysis. Data were obtained using Depression, Anxiety, and Stress Scale to assess symptoms on dimensional basis and using Mini International Neuropsychiatric Interview to diagnose on categorical basis. Mean age of students was 19.3 years with an average education of 14.7 years. Ranging from mild to extremely severe, depressive symptoms were present in 18.5% of the population, anxiety in 24.4%, and stress in 20%. Clinical depression was present in 12.1% and generalized anxiety disorder in 19.0%. Comorbid anxiety and depression was high, with about 87% of those having depression also suffering from anxiety disorder. Detecting depressive, anxiety, and stress-related symptoms in the college population is a critical preventive strategy, which can help in preventing disruption to the learning process. Health policies must integrate young adults' depression, stress, and anxiety as a disorder of public health significance. Copyright © 2010 by Lippincott Williams & Wilkins. Source

Mishra B.R.,Center for Cognitive Neurosciences | Nizamie S.H.,Central Institute of Psychiatry | Das B.,Center for Cognitive Neurosciences | Praharaj S.K.,Center for Cognitive Neurosciences

Objective To study the anticraving efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) of the right dorsolateral pre-frontal cortex (DLPFC) in patients with alcohol dependence. Methods We performed a prospective, single-blind, sham-controlled study involving 45 patients with alcohol dependence syndrome (according to ICD-10 DCR), with Clinical Institute of Withdrawal Assessment in Alcohol Withdrawal (CIWA-Ar) scores ≤10. Patients were allocated to active and sham rTMS in a 2 : 1 ratio, such that 30 patients received active and 15 patients sham rTMS to the right DLPFC (10 Hz frequency, 4.9 seconds per train, inter-train interval of 30 seconds, 20 trains per session, total 10 sessions). The Alcohol Craving Questionnaire (ACQ-NOW) was administered to measure the severity of alcohol craving at baseline, after the last rTMS session and after 1 month of the last rTMS session. Results Two-way repeated-measures analysis of variance (ANOVA) showed significant reduction in the post-rTMS ACQ-NOW total score and factor scores in the group allocated active rTMS compared to the sham stimulation. The effect size for treatment with time interaction was moderate (η 2 = 0.401). Conclusions Right dorsolateral pre-frontal high-frequency rTMS was found to have significant anticraving effects in alcohol dependence. The results highlight the potential of rTMS which, combined with other anticraving drugs, can act as an effective strategy in reducing craving and subsequent relapse in alcohol dependence. © 2010 Society for the Study of Addiction. Source

Sarkar S.,Central Institute of Psychiatry | Sinha V.K.,Central Institute of Psychiatry | Praharaj S.K.,Kasturba Medical College
Social Psychiatry and Psychiatric Epidemiology

Purpose: There is a dearth of research on the prevalence of depressive disorders in children from suburban and rural areas in the Indian subcontinent. Therefore, the present study was aimed at assessing the prevalence of depressive disorders and the associated risk factors in the primary and secondary school children in suburban India. Methods: This was a cross-sectional, school-based epidemiological study involving 1,851 children from standard I to VII age group. Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS-PL), a semi-structured interview was used to diagnose depression in this sample. Results: Using K-SADS-PL, prevalence of depressive disorder was 3.13% (n = 58); major depressive disorder was diagnosed in 15 (0.81%), dysthymia in 28 (1.51%) and depressive disorder NOS in 15 (0.81%). Age (OR 1.396, CI 1.121-1.738), class attendance (OR 0.251, CI 0.103-0.613), family history of psychiatric illness (OR 0.204, CI 0.069-0.605) and birth complications (OR 0.128, CI 0.029-0.558) emerged as significant predictors of depression; the model explained 24.1-32.3% of the variance in this sample. Conclusion: The present study confirms the findings from previous studies that childhood depression is a distinct diagnostic entity affecting a significant number of children and adolescents. © Springer-Verlag 2011. Source

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