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.

Covert Conditioning for Persistent Aggressive Behaviors: A Case Illustration.

In psychotherapy practice and training, single case study design plays an indispensable role by effectively articulating the application of textbook knowledge, thereby bridging the gap between theory and practice. This article, on similar lines, illustrates one such successful example of the application of the classical behavioral technique of covert conditioning modified with a component of verbal challenging. A woman in her late-thirties reported with long-standing seemingly-resistant-to-treat symptoms of aggressive behavior of beating children. The client had a total of 10 daily sessions of 60-90 minutes each. By the end of one week, she reported not beating children in this period. She felt extremely relieved because it had happened for the first time in 10 years. The intensity of anger had decreased drastically, and she was not shouting any longer. She had to discontinue sessions abruptly due to unavoidable circumstances. Although she was suggested to follow up the intensive sessions again, she was not able to do it due to feasibility issues. The improvement was maintained on follow-up visits after two weeks, four weeks, and three months.

Prevalence and predictors of depression in type 2 diabetes mellitus.

BACKGROUND: Type 2 diabetes mellitus (DM) is a multifactorial disease and can be described as a noncommunicable disease of epidemic magnitude. Little is known about the predictors of depression in this population, especially among the Indian population. This study explores the predictors for depression in patients with type 2 DM. MATERIALS AND METHODS: A cross-sectional study was performed for a period of 7 months during 2018-2019. The data were collected from 250 subjects at the diabetic clinic and psychiatry outpatient department of a tertiary care teaching hospital. T2DM with an age group of 18-60 years were included. Exclusion criteria were clinical evidence of any significant Axis I psychiatric disorder according to the International Classification of Diseases-10 Diagnostic Criteria for Research other than depression and substance use disorders. Data were analyzed with multiple linear regression analysis using SPSS-23 version. RESULTS: Male and female patients were 127 (50.80%) and 123 (49.20%), respectively. The prevalence of depression was 49.20% among 250 patients with T2DM. Female patients had higher depression than male patients. We found age (P = 0.013), female gender (P = 0.041), locality of the patient (P = 0.021), body mass index (BMI) (P = 0.018), and fasting blood sugar (FBS) (P = 0.045) as significant predictors of depression among T2DM patients. CONCLUSIONS: The study concludes that females and elderly patients were more affected by depression. The predictors of depression were age, gender, locality, BMI, and FBS among diabetic patients. The findings indicate to screen the patients of T2DM for depression, predominantly female and elderly patients, at regular intervals as per clinical demand.

Change in Attitude among Nursing Undergraduate Students Following One-Month Exposure in a Mental Healthcare Setting.

BACKGROUND: Attitude of treating professionals plays an important role in the treatment of mental illnesses. Nursing professionals are an important part of the mental health care team. As a part of their nursing coursework, nursing students are posted in a mental health setting. It is important to assess the impact of such postings on their attitudes. MATERIALS AND METHODS: A total of 235 undergraduate nursing students posted in a mental healthcare setting for one month participated in the study. Their attitude towards mental illness and psychiatry was assessed before and after the posting, using Personal data sheet, Attitude Scale of Mental Illness (ASMI), and Attitude towards Psychiatry Scale (ATP). RESULTS: At pre-assessment, the nursing students had a negative attitude on all dimensions of ASMI except benevolence, and positive attitude on all the six domains of ATP. At post-assessment, attitude improved significantly on pessimistic prediction dimension of ASMI, and they were able to maintain their positive attitude on ATP. CONCLUSIONS: One-month posting had a weak positive impact on attitude towards mental illness and no detrimental impact on attitude towards psychiatry. There is a need for better efforts to increase the impact of training on attitude towards mental illness.

A case of pseudoseizures precipitated by anticonvulsant toxicity.

We report a case of induction of pseudoseizures by anticonvulsant toxicity in a patient with underlying seizure disorder, hence supporting the argument of an organic subtype of pseudoseizure.