Psychometric properties and factor structure of the suicidal narrative inventory in major depression: A multicentric evaluation.

BACKGROUND: The Suicidal Narrative Inventory (SNI) is a 38-item self-report measure developed to assess elements of the suicidal narrative, a subacute, predominantly cognitive, presuicidal construct. Our objectives were to assess the factor structure, validity, and reliability of the SNI-38 among adults with major depressive disorder (MDD). METHODS: Using a cross-sectional design, we administered the Hindi version of the SNI along with other self-report measures to adults with MDD, recruited from 24 tertiary care hospitals across India. Confirmatory factor analysis (CFA) was performed to assess the factor structure of SNI-38. Reliability (internal consistency) was assessed using Cronbach's alpha (α). Convergent, discriminant, and criterion validity of the SNI-38 were tested by comparing it against other appropriate measures. RESULTS: We collected usable responses from 654 Hindi-speaking participants (Mean age = 36.9 ± 11.9 years, 50.2% female). The eight-factor solution of the SNI showed good model fit indices (χ2[637] = 3345.58, p <.001, CFI =.98, and RMSEA =.08). Internal consistencies for the SNI subscale scores were good to excellent, α ranging from .73 to.92. While most subscales significantly converged with other measures, associations were comparatively weaker and inconsistent for the 'thwarted belongingness' and 'goal reengagement' subscales. CONCLUSION: Consistent with prior data, our study confirmed an eight-factor solution and demonstrated adequate psychometric properties for the Hindi version of the SNI-38 in our sample. These findings provide empirical support for the use of SNI to assess the suicidal narrative among Indian adults with MDD.

A comparative study of the effect of electroconvulsive therapy and transcranial direct current stimulation in the treatment of persons suffering from treatment-resistant depression.

Background: About 20%-30% of persons with major depression are said to have treatment-resistant depression (TRD) when they do not respond to antidepressants. These people continue to suffer in life and have poor quality of life. Although electroconvulsive therapy (ECT) is the most successful option in treating TRD, many people refuse ECT due to various reasons (stigma, the cost involved, and medical complications). Various studies combine treatment options such as psychotherapy, repetitive trans magnetic stimulation, ketamine, and transcranial direct current stimulation (tDCS) in an attempt to reduce symptoms for those people suffering from TRD. This study aims to compare the effectiveness of ECT and tDCS in TRD. Subjects and Methods: A total of 90 persons suffering from TRD were selected for the study. 46 persons received 6 ECTs and 44 persons received 10 sessions of tDCS. Treatment response was measured using baseline and postassessment scores of Hamilton depression rating scale and clinical global impression. The scores were used to determine the effectiveness of ECT in comparison to tDCS in TRD. Statistical Analysis: The mean ± standard deviation was analyzed and paired t-test was used to find the significance of treatment outcome in a group at a 95% confidence interval. Results: ECT was found to be more effective than tDCS in the reduction of depressive symptoms. tDCS showed a significant reduction in depressive symptoms (P < 0.001). ECT has yet again been proven to be effective in the treatment of TRD. Conclusion and Discussion: tDCS is effective in reducing depressive symptoms in persons suffering from TRD. However, ECT is superior in decreasing depressive symptoms in TRD when compared to tDCS.

A Cross-Sectional Study on Internet Addiction Among Adolescent Children of Parents With Mental Illness.

BACKGROUND: The internet can cause adverse psychological issues in children whose parents show less competence because of their mental illness. This study aims to find the level of internet addiction among adolescents who have a parent with psychiatric illness and its relationship to the type and duration of their parent's illness. METHOD: This study was conducted among 283 adolescents whose parents suffered from mental illness. They were selected from the inpatient and outpatient services of a neuropsychiatric hospital in India. Informed written consent was obtained from the parent not suffering from psychiatric illness, and a semistructured interview accommodating various factors and statements from the internet addiction test was used to find the level of internet addiction. RESULT: A total of 79.5% of adolescents showed scores indicative of internet addiction, with 14.5% of the participants having mild levels of addiction, 60.8% having moderate levels of addiction, and 4.2% having severe levels of addiction. There is a significant relationship between internet addiction scores and the type and duration of psychiatric illness in a parent. CONCLUSION: The internet addiction scores in adolescents have a significant relationship to the various types of illnesses and the duration of illness of their parents.

Endoxifen: A new, protein kinase C inhibitor to treat acute and mixed mania associated with bipolar I disorder.

OBJECTIVES: Endoxifen is a protein kinase C inhibitor. The objective of the present phase III study was to demonstrate the safety and efficacy of endoxifen in treating bipolar I disorder (BPD I) patients. METHODS: A multicenter, double-blind, active-controlled study was conducted using a daily dose of 8 mg endoxifen compared to 1000 mg divalproex, the current standard treatment, in patients with BPD I acute manic episodes with/without mixed features. The primary endpoint of our study was the mean change in total Young Mania Rating Scale (YMRS) score at day 21. RESULTS: Endoxifen (n = 116) significantly (p < 0.0001) reduced total YMRS score (from 33.1 to 17.8. A significant (p < 0.001) improvement in Montgomery-Åsberg Depression Rating Scale (MADRS) score was observed for endoxifen (4.8 to 2.5). Early time to remission of the disease was observed with endoxifen compared to divalproex. None of the patients required rescue medication and there was no drug-associated withdrawals. Changes in Clinical Global Impressions-Bipolar Disorder and Clinical Global Impression-Severity of Illness scores showed that treatment with endoxifen was well-tolerated. CONCLUSIONS: Endoxifen at a low daily dose of 8 mg was as efficacious and safe in patients with BPD I acute manic episodes with/without mixed features.

Statewide Survey of Psychological Distress Among People of Tamil Nadu in the COVID-19 Pandemic.

BACKGROUND: COVID-19-driven pandemic has caused panic, fear, and stress among all strata of society. The study aimed to assess stress and the factors that influence it in a representative population in the state of Tamil Nadu (TN)-a state in the southern India where the levels of stress have not been measured yet. METHODS: From April 13 to April 25, 2020, we conducted an online survey among the TN population using the snowball sampling technique, collecting basic demographic data. COVID-19-perceived stress was collected through COVID-19 Peritraumatic Distress Index (CPDI). Binomial regression analysis was used to identify the extent of the relationship between CPDI and sociodemographic factors by estimating the odds of having significant stress. P ≤ 0.05 was considered significant. RESULTS: A total of 2,317 valid responses were received. Of the respondents, 830 (35.82%) were males, 1,084 (46.79%) were below 25 years of age, and 2,297 (99.14%) were native residents of TN. The mean(±SD) CPDI was 20.66±12.03. While 1,830 (77.2%) respondents had low or no stress, 478 (20.2%) had mild to moderate stress, and 63 (2.7%) had severe stress. The bivariate model included marital status, age, nativity, and income. The odds of having significant stress (mild-moderate or severe) for a 25-34 year age group as compared to >55 years group was 2.38 (P < 0.001). As compared to widowed, the married had higher odds ratio (3.41, P = 0.05). Compared to those with >10 lakh annual income, those with 2.5-5 lakhs annual income had odds ratio of 1.65 (95% CI = 1.01 to 2.7, P = 0.05). CONCLUSIONS: During the lockdown due to COVID-19, every 1 in 5 TN population had some form of stress, as measured by CPDI. Our model identified certain factors driving the stress, which would help policy framers to initiate an appropriate response.

Caregiver burden in children with intellectual disability: Does special school education help?

BACKGROUND: Caregivers are playing a vital role in mentally ill patients in India. Families of children with intellectual disability encounter a high degree of stress such as physical, emotional, and financial. AIM: The aim of this study was to compare and evaluate the caregiver burden and depression between the special school-going children and nonschool-going children with intellectual disability. MATERIALS AND METHODS: The present study was conducted on caregivers of patients with intellectual disability at Radianz Health Care and Research Private Limited, Ahana Hospitals, Akash Special School, and M. S. Chellamuthu Trust and Research Foundation, Madurai. The Zarit Burden Interview scale was utilized to assess the level of burden experienced by the caregivers. The Major Depression Inventory scale was utilized to assess the severity of depression experienced by the caregivers. The Binet Kamat Test of Intelligence was administered by a psychologist to assess the IQ level of the children. RESULTS: Totally 80 caregivers were participated in the study. The mothers of children with intellectual disability suffered from burden and depression when compared to the fathers (P < 0.0001). The parents of nonschool-going children had a higher level of burden and depression as compared to the parents of special school-going children (P < 0.0001). CONCLUSION: Special school is playing a vital role for children with intellectual disability. It can be reasonably concluded from the study that both the groups face burden and depression. However, the severity of burden and depression is comparatively higher among parents of nonschool-going children.