Association of miR-155, miR-187 and Inflammatory Cytokines IL-6, IL-10 and TNF-α in Chronic Opium Abusers.

Substance use disorders are known to be associated with inflammation. However, the dynamics of inflammatory cytokines and microRNA in chronic opium use is yet unexplored. The current study determined the levels of inflammatory cytokines TNF-α, IL-6, IL-10 and immune-regulatory miR-155 and miR-187 expressions in chronic opioid use disorder. Adults (n = 48) meeting the 5th Edition of the DSM criteria regarding opioid use disorder and healthy controls (n = 46) were included in the study. Inflammatory cytokines IL-10, IL-6, and TNF-α were analyzed from serum samples, and peripheral blood mononuclear cells processed for miRNA expression. Cases showed significantly raised IL-10 and TNF-α and reduced IL-6. Dose-dependent upregulation of miR-155-5p and miR-187-5p was evident at opium dose >1500 g/month, with a corresponding increase of TNF-α and IL-10. MiR-155 showed a significant positive correlation with IL-6 and TNF-α levels, while miR-187 showed a significant negative association with TNF-α at ≥1000 g/month consumption. Therefore, increasing consumption of opium probably enhances inflammation leading to immunomodulation and aberrant expression of hsa-miR-155-5p and hsa-miR-187-5p in opioid use disorder.

Kriya Yoga in Patients with Depressive Disorders: A Pilot Study.

Background and Objectives Despite the easy acceptability and holistic nature of Kriya yoga, there are no studies evaluating the role of Kriya yoga intervention on depression. The objective of the current study was to assess the feasibility and effect of adjunctive Kriya yoga on depression. Methods Patients with major depressive disorder who opted for Kriya yoga were recruited into the intervention group (adjunctive Kriya yoga) and those on psychotropic medication alone were enrolled into the control group. The Hamilton Depression Rating Scale (HDRS) measurements were recorded at baseline, end of 2, 4, and 8 weeks. Results HDRS scores of the intervention group ( n = 29) were found to be significantly lesser than that of the control group ( n = 52) by the end of 2, 4, and 8 weeks. The remission rate was also significantly greater in the intervention group. Conclusion Kriya yoga intervention was found to be feasible, as well as improved the severity of depression.

Relapse in bipolar disorder in hospitalized patients with COVID-19: A case series and key recommendations.

COVID-19 has adversely affected the lives of people with bipolar disorder (BD). We have reported three patients with BD, who suffered from relapse after being diagnosed with COVID-19. Patient X is a 54-year-old man who developed manic episode, while Y is a 63-year-old man and Z is a 52-year-old woman who developed severe depression after being hospitalized for COVID-19. In this case series, three patients with BD who developed manic or depressive episodes during COVID-19 infection have been described. Adequate liaison between consultation-liaison psychiatrist and primary medical team was done. Rational pharmacotherapy along with psychosocial interventions led to favorable outcomes in all three cases.

Prevalence of psychiatric disorders among older adults in Jodhpur and stakeholders perspective on responsive health system.

BACKGROUND: Ageing is an inescapable reality of human existence. The elderly population of India is steadily increasing with growing mental health needs which pose many challenges for the health care system. The aim of this study is to assess anxiety, depression, and cognitive disorders among urban and rural elderly and to explore the availability of social support mechanisms and a responsive health system for elderly. METHODS: This study is a mixed-method approach. For a quantitative study, a community-based cross-sectional survey is conducted in Jodhpur, Rajasthan. A total of 330 elderly persons aged 60 years and above are randomly screened for depression (GDS), anxiety (GAD), and cognitive impairment (HMSE). Further for a qualitative study, in-depth interviews are conducted with 7 key informants including policy and program managers, service providers, and facilitators from the state. For quantitative data analysis, Excel and SPSS are used and for Qualitative data analysis, Thematic Framework Approach is used. RESULTS: The mean age of the respondents is 67.9 ± 7.8. The prevalence of severe depression is 17%, severe anxiety is 10.3%, and cognitive impairment is 51.2%. The prevalence of all the three is more in rural elderly as compared to urban elderly as well as more in female individuals as compared to males. Qualitative analysis revealed that there are challenges in early identification of mental disorders at both the levels: service providers and elderly. Psychological and financial issues are also seen in elderly who are not supported by their children. There are cases of fear for elder abuse and influence of western culture in the society. CONCLUSION: There is a sizeable prevalence of psychological issues in elderly population. Therefore, there is a need to adopt holistic and integrated psychogeriatric services for the improvement of quality of life in elderly.

Vitamin D and Depression: A Critical Appraisal of the Evidence and Future Directions.

BACKGROUND: Growing evidence points to the role of vitamin D in the pathobiology and treatment of depression. However, the evidence is inconsistent in many aspects. The objectives of this narrative review were to evaluate the state of the evidence, synthesize the knowledge gaps, and formulate recommendations for more enhanced research in this growing area. METHODS: Electronic searches of MEDLINE via PubMed, Cochrane Library, and Google Scholar databases were carried out from inception till February 2019 to identify relevant English language peer-reviewed articles. Abstracts generated were systematically screened for eligibility. Included articles were grouped under three broad themes: The association between vitamin D and depression, its biological underpinnings, and trials evaluating the efficacy of vitamin D supplementation in depression. Relevant data were extracted as per a structured proforma. RESULTS: A total of 61 articles were included in the present review. Overall findings were that there is a relationship between vitamin D and depression, though the directionality of this association remains unclear. The association appears to be driven by the homeostatic, trophic, and immunomodulatory effects of vitamin D. Evidence from supplementation trials suggest a more robust therapeutic effect on subjects with major depression and concurrent vitamin D deficiency. CONCLUSION: Serum vitamin D levels inversely correlate with clinical depression, but the evidence is not strong enough to recommend universal supplementation in depression. Enriching depression treatment trials with subjects having concurrent vitamin D deficiency appears to be a potential step forward in identifying subgroups who may maximally benefit from this approach.