Effectiveness of add-on yoga in reducing the symptoms of obsessive compulsive disorder (OCD): A randomized controlled trial.

BACKGROUND: The standard treatments for Obsessive Compulsive Disorder (OCD) have been pharmacological and psychotherapeutic, with preliminary evidence for yoga as an intervention. AIM: To test the short-term effects of a validated yoga intervention as an adjunct to medication in patients with OCD. SETTINGS AND DESIGN: The study included patients diagnosed with OCD attending a tertiary psychiatry hospital in south India using a Randomized Controlled Trial (RCT) design. METHODS: The study included 50 patients with OCD who were randomized into yoga group (n=25) and waitlist control group (n=25). All patients continued medication during the period of study. 42 subjects (Yoga=20, waitlist control=22) completed the study period of 4 weeks. Patients in the yoga group received 10 supervised sessions of a validated yoga module for OCD and continued home practice for next 20 days. Patients were rated on the Yale Brown Obsessive Compulsive Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale and Brown Assessment of Beliefs Scale at baseline and end of 4th week by raters who were blind to group status. For qualitative assessment, subjects were interviewed individually till data saturation was reached (n=11). RESULTS: Patients randomized to yoga showed significant improvement in Obsessions (p-<0.001) (η2-1.3), Compulsions (p-0.007) (η2-0.8), Anxiety (p-0.002) (η2-1.0) and Depression (0.003) (η2-0.9) scores compared to patients in the waitlist control group. Qualitative results showed that yoga was efficacious in improving physical, mental, and overall health. CONCLUSION: Yoga-based intervention as an adjunct to medication was effective in reducing symptoms in outpatients with OCD over 4 weeks.

Altered vascular permeability but not angiogenesis may play a role in the epileptogenesis of human hippocampal sclerosis.

OBJECTIVE: We investigated the role of angiogenesis and vascular permeability in the pathogenesis of human drug-resistant epilepsy due to hippocampal sclerosis. METHODS: Resected hippocampi from 30 histologically confirmed cases of hippocampal sclerosis and 30 age-matched post-mortem controls were examined by immunohistochemical quantitation of vascular endothelial markers, CD31 and CD105 (markers of newly formed vessels), and data were analysed relative to MR volumetry. The blood-brain barrier was evaluated based on immunohistochemistry for IgG, albumin, VEGF and AQP4. RESULTS: Mean vascular density in the hippocampus was 8.71/mm2 in hippocampal sclerosis samples compared to 7.94/mm2 in age-matched controls. No statistically significant increase in vascular density was found in hippocampal sclerosis samples. Although no neoangiogenesis was found in hippocampal sclerosis samples based on CD105, breakdown of the blood-brain barrier, enhanced neuronal expression of VEGF, and perivascular seepage of IgG and albumin with uptake within neurons and astrocytes were found. Redistribution of the water channel protein, AQP4, reflected by change from normal punctate labelling to intense diffuse staining in hippocampal sclerosis samples, indicated an altered glia-vascular interface, disrupting blood-brain barrier permeability. SIGNIFICANCE: Our data show no objective histological evidence of angiogenesis in hippocampal sclerosis samples. When controlled for the confounding variable of hippocampal area, there was no difference in vascular density between cases and controls. A leaky blood-brain barrier and redistribution of AQP4 were identified which may contribute to epileptogenesis. This constitutes the largest study in the published literature evaluating a role of vascular permeability and angiogenesis in human hippocampal sclerosis.

Predictors of non-suicidal and suicidal self-injurious behaviours, among adolescents and young adults in urban India.

BACKGROUND: The complex intersections between non-suicidal self-injurious (NSSI) behaviours; like cutting, burning or self-hitting, and suicide attempts, are an important domain of enquiry among vulnerable adolescents and young adults. A cross-sectional survey in urban schools and colleges assessed the rates of self-injurious behaviour among Indian adolescents and young adults. Predictors of NSSI and of self-injurious behaviours with associated suicidal intent, were also examined. PARTICIPANTS AND METHODS: The sample comprised 1571 male and female students, from 19 private and government aided high schools, pre-university colleges and undergraduate colleges in an urban city in South India. Participants completed the Functional Assessment of Self-Mutilation which assesses the methods, characteristics and functions of self-injurious acts in the past 12 months. The measures of psychopathology included the Youth Self-Report and the Young-Adult Self-Report. RESULTS AND CONCLUSION: The results indicated that rate of NSSI was 33.8%, with minor forms of self-injury reported more often (19.4%) than the moderate/severe forms (14.6%). A smaller proportion (6.8%) reported self-injurious acts with associated suicidal intent. Certain self-injury characteristics and levels of internalizing and externalizing problems differentiated self-injuring youth with and without suicidal intent. Logistic regression analyses identified predictors of any self-injurious behaviour and of self-injury associated with suicidal intent. The implications for assessment and intervention frameworks for self-injuring youth are discussed.

Perception of family emotional climate by family members of persons with schizophrenia.

BACKGROUND: There is a dearth of instruments to assess schizophrenia persons' Family Emotional Climate (FEC). AIM: This study aims to explore the relation between family members' personality traits and FEC. METHODS: We invited a convenience sample of 50 both gender family members who were accompanying the person with schizophrenia for out-patient department (OPD) consultation to provide data on a socio-demographic proforma and the researcher prepared 'Emotional climate assessment questionnaire - caregivers' version' (ECAQ-C) as well as the Eysenck personality questionnaire. RESULTS: Caregivers' extroversion traits (r = .427, p = .002) were positively correlated and neuroticism traits were negatively correlated (r = -.330, p = .019) with their positive perception of FEC. There was a higher perception of positive FEC (mean scores = 65.5 ± 10.5) while caregivers seemed to perceive less negative FEC (mean scores = 36.5 ± 10.2). Caregivers with education above 11th std perceived less (χ(2) = 8.6, p = .013) of negative FEC. CONCLUSION: The findings highlight that caregivers' personality traits seem to influence the FEC. While caregivers' perception of FEC is positive in this study, those in the higher education group seem to have a better perception of FEC indicating that education also may influence FEC.

Glial alterations in tuberculous and cryptococcal meningitis and their relation to HIV co-infection--a study on human brains.

INTRODUCTION: Tuberculosis and cryptococcal infection of the central nervous system are common AIDS-associated opportunistic infections in tropical underdeveloped and developing countries. To date, research on these infections has focused on clinical, imaging, laboratory diagnosis, and animal models to elucidate the pathogenesis. There is paucity of information on astroglial and microglial alterations in the human nervous system following these infections. METHODOLOGY: The pathomorphologic and morphometric alterations of astroglia and microglia in the prefrontal cortex and hippocampus in cases of tuberculous meningitis (TBM) and cryptococcal meningitis (CM) with and without associated HIV were described and compared with cases of HIV encephalitis without opportunistic infections (OI) and HIV-negative human brain tissue. RESULTS: In TBM, the microglia and astrocytes were activated with hypertrophy and hyperplasia, aggregating in the subpial zone and around granulomas in meningeal exudate. In cases of cryptococcal meningitis, reactive changes were less prominent, though activation of both cellular elements was found. Association of HIV with these OIs resulted in muted glial and microglial response. In HIV encephalitis without OI, the level of activation of was low. Both astroglial and microglial cells expressed caspase-3, a pro-apoptotic marker, following HIV and opportunistic infections. Neuronal apoptosis, a mechanism to ensure neuronal survival, was less evident. The reactive astrocytes and microglia following opportunistic infection developed dystrophic changes heralding senescence. CONCLUSIONS: Further studies on neuronal-astroglial-microglial interaction will offer deeper insight into the pathogenetic and immune mechanisms in the cellular and pathomorphological evolution of tuberculous and cryptococcal infections.