District-level differences in the distribution of mental and substance use disorders in Assam.

Background: The lifetime prevalence of mental morbidity in Assam is estimated at 8% (NMHS 2015-16). Understanding the distribution patterns of different types of mental disorders among persons with mental morbidity in different districts would facilitate evidence-driven district mental health programming in Assam. Given the varied socio-geopolitical situation across districts in Assam, significant variations in the distribution of mental disorders are expected. Aims: To assess interdistrict differentials in common mental disorders (CMDs), severe mental disorders (SMDs), socioeconomic impact, healthcare utilization, and mental disability across three districts sampled in NMHS in Assam. Materials and Methods: This cross-sectional study used stratified random cluster sampling to identify and study eligible adult participants in Dibrugarh, Barpeta, and Cachar districts. Standardized scales and validated questionnaires were used to assess mental morbidity, disability, socioeconomic impact, and healthcare utilization. The distribution of different mental disorders among persons with mental disorders and their interdistrict differentials were tested using the Chi-square test of significance. Results: Among persons with mental morbidity, the most common disorder was CMDs (79%). The proportional distribution of CMDs among persons with mental morbidity was significantly higher in the Dibrugarh district (79%), whereas the distribution of SMDs was higher in the Cachar district (55%). The distribution of alcohol use disorder was the highest in the Dibrugarh district (71.6%). Significant differences in disability and healthcare utilization were observed between the districts. Conclusions: NMHS 2015-16 Assam indicates significant differentials in the distribution of CMDs and SMDs, healthcare utilization, and associated disability between the three districts. The differentials necessitate further research to understand socio-ethnocultural, religious, geopolitical, and other factors influencing the distribution. These differences need to be accounted for during the implementation of mental health programs in the state.

Depiction of Obsessive-Compulsive Disorder in YouTube videos.

Videos on obsessive-compulsive disorder (OCD) are widely available on YouTube. Individuals with OCD and their caregivers would likely watch these videos to understand this disorder. Videos presenting the information related to symptomatology and available treatment accurately and in an easy-to-understand manner would benefit the patients and the caregivers. On the other hand, inaccurate information may create confusion. Given this, the present research is aimed at analyzing the content, accuracy, and appropriateness of the YouTube videos on OCD. The quality of the YouTube videos on OCD, in terms of accuracy of the information provided, was assessed. Out of 330 videos, resulting from various search terms, 82 were found to be suitable for analysis. The videos were assessed for the accuracy of presented content on clinical symptoms, biological underpinnings, and treatment (pharmacological and non-pharmacological) as well as their educational utility. Majority of the videos provided accurate description of obsessions (82.9%) and compulsions (74.4%) and 21.9% of the videos mentioned biological underpinnings of OCD. Treatment options, both pharmacotherapy and psychotherapy, were mentioned in 32.71% and 41.5% of the videos, respectively. Overall, 69.5% of the videos had useful educational utility. Findings have been discussed in terms of their practical utility.

Impaired recollection-based episodic memory as a cognitive endophenotype in schizophrenia.

INTRODUCTION: Patients with schizophrenia show impaired recollection but largely preserved familiarity-based episodic memory. This study was done to clarify the endophenotypic nature of recollection and familiarity-based episodic memory in schizophrenia and the role of emotional valence of memoranda and degree of recall confidence in it. METHOD: Twenty-five patients with schizophrenia, one unaffected sibling of each patient, and twenty-three healthy controls completed two tasks assessing recollection and familiarity-based processes in episodic memory. In the first task, participants were asked to remember positive, negative, and neutral emotional valence words in a remember-know paradigm. In the second task, in addition to recollection and familiarity-based responses, participants were asked to make confidence judgments about their responses. RESULTS: Patients with schizophrenia and their first-degree relatives (FDRs) performed poorly on recollection but not familiarity-based responses, compared to healthy controls; performance of first-degree relatives was in between and significantly different from that of both patients and controls. The differences in recollection and familiarity-based responses across the three groups were not moderated by recall confidence judgments or emotional valence of memoranda. Furthermore, there was no correlation between recollection-based memory impairments and duration or severity of illness or current medication exposure. CONCLUSIONS: Impaired recollection-based memory constitutes a potential cognitive endophenotype in schizophrenia. Furthermore, selective impairment of recollection-based, but sparing of familiarity-based, memory in patients and their FDRs supports the distinct nature of recollection and familiarity-based episodic memories.

Lower P300 amplitudes for internally-generated events in patients with schizophrenia.

BACKGROUND: Patients with schizophrenia demonstrate difficulty differentiating internally-generated from externally-generated events. An excessive deployment of attention to external events as well as poor processing of self-generated events has been proposed to explain this misattribution. This study was done to understand the neurophysiological basis of source monitoring bias in schizophrenia. METHODS: Seventeen patients and fourteen healthy controls completed a two-stage source monitoring task involving solving a three-letter jumbled word either by the participant or a computer following which they had to identify the correct source of the word - solved by self (internal source monitoring, ISM) or by computer (external source monitoring, ESM) - while EEG was recorded. P300 amplitude and latency were computed separately for ISM and ESM conditions. RESULTS: P300 amplitude for ISM condition was lower in patients with schizophrenia compared to controls over right and left parietal regions. Additionally, P300 amplitude for ISM condition was lower compared to ESM condition in patients over right and left parietal regions. However, P300 amplitude for ESM condition did not differ significantly between the groups. In contrast to P300 amplitude, there was no significant difference in P300 latency in ISM or ESM condition within or between the groups. CONCLUSION: P300 amplitude was lower for internally-generated but not externally-generated events in patients with schizophrenia. These findings suggest that patients allocate less attentional resources to internally generated events resulting in poorer processing and consequent misattribution of their source of origin. This study provides the first specific electrophysiological evidence of impaired source monitoring in schizophrenia.

Identification of suicidal ideations with the help of projective tests: a review.

Identification of the presence of suicidal ideations in an individual is crucial for the timely intervention. However, these ideations may remain unidentified as an individual with serious intentions of self-harm may not express them explicitly. Various projective tests can provide crucial clues to clinicians about the presence of suicidal ideations in an individual's mind. The present review is intended to update clinicians working in the field of suicide prevention about salient findings on these tests which can serve as a ready reckoner for them. We also highlight the status of research in this domain.

Long-term concentrative meditation and cognitive performance among older adults.

BACKGROUND: The general consensus that cognitive abilities decline with advancing age is supported by several studies that have reported that older adults perform more poorly on multiple tests of cognitive performance as compared to younger adults. To date, preventive measures against this cognitive decline have been mainly focused on dietary, physical, and lifestyle behaviors which could allow older adults to maintain their cognitive abilities into late life. However, much less stress has been laid on evaluating meditation as a preventive measure in such cases in spite of the fact that the role of meditation on attention has been proved in several studies. In the current study, we extend this preliminary idea, examining the practice of concentrative meditation and the differences in the cognitive performance of older adults who have or have not employed this practice long term. METHODOLOGY: This was a cross-sectional study comparing the cognitive performance of meditators and non-meditators in the geriatric age group. Twenty (age > 55 years) long-term practitioners of Vihangam Yoga meditation (>10 years of practice) were recruited in the present study and were applied six paper-pencil neuropsychological tests for assessment of short-term memory, perceptual speed, attention, and executive functioning. The tests used were: (1) the Digit Span test, (2) the Stroop Color Word test, (3) the Trailmaking test, (4) the Letter Cancellation Task, (5) the digit symbol substitution test, and (6) the Rule Shift Card Test. All the tests were also applied to 20 age- and education-matched geriatric adults who have not practiced the meditation technique. RESULTS: Vihangam Yogis showed significantly better performances in all these tests of attention (p < .05) except for the digit backward test, where a trend (p = .08) was found in favor of meditators. CONCLUSION: Long-term Vihangam Yoga meditators have superior cognitive abilities than non-meditators in the old age group. This technique should be studied further for its ability to prevent age-related cognitive decline.

Long-term Vihangam Yoga meditation and scores on tests of attention.

Although the literature indicates that meditation has beneficial effects on several aspects of human functioning, few studies have specifically investigated the effects of meditation on various domains of attention. This study was conducted to examine the differences in various domains of attention between long-term concentrative meditators versus matched controls. 15 practitioners of Vihangam Yoga (> 10 yr. experience) were enrolled in the study. Controls matched on age, sex, and years of education were recruited. Both groups were administered the Stroop, Trail-Making, and Digit Symbol Substitution tests as well as the Digit Forward and Digit Backward tests. The group of Vihangam Yogis had significantly better mean performance on all tests of attention. Long-term Vihangam Yoga meditation improves attention span, processing speed, attention alternation ability, and performance in interference tests.