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 non-invasive method for prediction of neurodegenerative diseases using gait signal features.

The steady degeneration of neurons is the hallmark of neurodegenerative illnesses, which are, by definition, incurable. Corticobasal Syndrome (CS), Huntington's Disease (HD), Dementia, Amyotrophic Lateral Sclerosis (ALS), Progressive supranuclear palsy (PSP) and Parkinson's Disease (PD) are some of the common neurodegenerative diseases which has impacted millions of people, predominantly among the older population. Various computational techniques, including but not limited to machine learning, are emerging as discrimination and detection of neuro-related diseases. This research proposed a machine learning-based framework to correctly detect PD, HD, and ALS from the gait signals of subjects both in binary and multi-class detection environment. The detection approach proposed here combines the classification power of Naïve Bayes and Logistic Regression jointly in a modern UltraBoost ensemble framework. The proposed method is unique in its ability to detect neuro diseases with a small number of gait features. The proposed approach ascertains most essential gait features through three state-of-the-art feature selection schemes, infinite feature selection, infinite latent feature selection and Sigmis feature selection. It has been observed that the gait signal features of the subjects are identified through Infinite Feature Selection manifests better detection results than the features obtained through Infinite Latent Feature and Sigmis feature selection while detecting Parkinson's and Huntington's Disease in a multi-class environment. So far as the binary detection environment is concern, the Amyotrophic lateral sclerosis is detected with 99.1% detection accuracy using 18 Sigmis gait features, with 99.1% sensitivity and 98.9% specificity, respectively. Similarly, Huntington's disease was detected with 94.2% detection accuracy, 94.2% sensitivity, and 94.5% specificity using 5 Sigmis gait features. Finally, Parkinson's disease was detected with 98.4% sensitivity, specificity, and detection accuracy.

Association Between Loneliness and Suicidal Behaviour: A Scoping Review. / Yalnizlik ve Özkiyim Davranisi Arasindaki Iliskinin Kapsam Derlemesi.

OBJECTIVE: Suicide is a public health issue, and there are several factors leading to suicide, like mental illness and psychosocial stressors. Actual loneliness (living alone) and subjective loneliness (feeling of being alone) and different suicidal behaviors have been reported to have some link. This scoping review aimed to assess the association between loneliness and suicidal behaviour by exploring the existing literature. METHODS: A scoping review was conducted implementing the appropriate framework and in accord with the PRISMA-ScR extension. A PubMed database search was made using a combination of terms to find publications in English from 2011 to 2021. Studies were included if they reported quantitative outcomes of the association between loneliness and suicidal experiences, including suicidal thoughts, plans, and/or attempts. Screening and data charting of the published literature was conducted by a panel of authors. The accuracy and clarity of extracted data was checked by three reviewers. RESULTS: Among 421 articles found, 31 full texts were evaluated based on exclusion and inclusion criteria, out of which, 18 papers that reported quantitative outcomes of the association between loneliness and suicidal experiences were included. We found that association between loneliness and suicidal behaviour is determined by individual, social and cultural factors. Co-existing mental illness, substance use disorder and economic hardship play an important role for the completion of suicide. CONCLUSION: Loneliness is correlated with suicide, and the knowledge about this association could assist in the identification of suicidal individuals or those at elevated risk of suicidal behaviour. Future studies should focus on loneliness and its relation to suicidal ideation in individuals with different mental health disorders and personalities.

Improving depression and perceived social support enhances overall quality of life among myocardial infarction survivors: necessity for integrating mental health care into cardiac rehabilitation programs.

Background: Depression and low perceived social support (PSS) have been found to deleteriously affect quality of life (QoL) among myocardial infarction (MI) survivors. The complex relationship between these variables has not been assessed. We wanted to assess first the prevalence of depression among MI survivors and whether depression mediates the effect of PSS on QoL and, second, whether the physical and social domains of QoL mediated the effect of depression and PSS on the emotional domain. This cross-sectional study was done among MI survivors using Cardiac Depression Scale, MacNew Quality of Life After Myocardial Infarction Questionnaire and Multidimensional Scale of Perceived Social Support to assess for depression, QoL and PSS respectively. Results: A total of 103 MI survivors were included in the study, and the mean age was 59.66 (± 10.42) years. Depression was found in 21.36% of the participants. The indirect effect of PSS on QoL with depression as a mediator was significant (b = 0.15, p < 0.001, 95% CI 0.12, 0.18). The direct effect of PSS on QoL controlling for depression was also significant (b = 0.05, p < 0.001, 95% CI = 0.02, 0.07). Depression as a mediator in the relationship explained 75.3% of the effect of PSS on QoL. PSS and depression did not have a significant direct effect on emotional QoL, but it became significant when the physical and social domains were included in the model. The total indirect effects of PSS and depression on emotional QoL were b = 0.16, p < 0.001, 95% CI = 0.05, 0.17 and b = - 0.05, p < 0.001, 95% CI = 0.06, - 0.03, respectively. Conclusion: Depression and poor PSS impair physical and social domains, which impairs the emotional domain of QoL; as such, overall QoL is undermined. As limited physical and social activity because of depression and poor PSS may increase the risk of further cardiovascular events, a holistic approach which includes mental health care is warranted.

Internalized and Perceived Stigma and Depression in Pulmonary Tuberculosis: Do They Explain the Relationship Between Drug Sensitivity Status and Adherence?

Background: Adherence to medication for tuberculosis (TB) has been found to be deleteriously affected by psychosocial issues, including internalized and perceived stigma (IPS) and depression, usually resulting in the emergence of multidrug-resistant TB (MDR-TB). The objective of the study was to find the prevalence of depression among patients receiving treatment for pulmonary TB, and how stigma and depression affect the relationship between drug sensitivity status (DSS) and treatment adherence. Method: It was a cross-sectional observational study conducted between January 2019 and July 2020 in two centers in Sikkim, India. The Patient Health Questionnaire-9 (PHQ-9), Internalized Social Stigma Scale (ISSS), and Tuberculosis Medication Adherence Scale were used to assess depression, IPS, and medication adherence, respectively. A path analysis was performed with DSS, treatment adherence, IPS, and depression. Education in years was included in the model as it was significantly correlated with IPS. Results: A total of 71 patients who were on drug-sensitive TB (DS-TB) regimen (n = 26) and MDR-TB regimen (n = 45) participated in the study. Notably, 56.3% (n = 40) of the participants were found to have depression. Among the depressed participants, 32.5% were on the DS-TB regimen and 67.5% were on the MDR-TB regimen. The path analysis indicated that IPS and depression were serially mediating the relationship between DSS and treatment adherence (ß = -0.06, p < 0.05, 95% CI = -3.20, -0.02). Finally, years of education had an exogenous predictor role, not only directly affecting IPS (ß = -0.38, p < 0.001, 95% CI = -0.99, -0.31) but also affecting treatment adherence through IPS and depression (ß = 0.08, p = 0.02, 95% CI = 0.03, 0.47). This indicated that with more years of education, the IPS decreases, which decreases depression and ultimately leads to better adherence. Conclusion: We found an important relationship between different psychosocial factors which may affect treatment adherence. Patients who have higher IPS are more likely to develop depression which negatively affect adherence. Patients on the MDR-TB regimen have higher stigma. There is an urgent need to integrate mental health services with TB Control Programs.

Lived Experiences of Wives of Persons with Alcohol Dependence Syndrome during COVID-19 Pandemic.

Background: There have been reports of increasing alcohol use and domestic violence among individuals with alcohol dependence syndrome during the COVID-19 pandemic. This study assessed the experiences of domestic violence, psychological distress, and coping mechanisms used by wives of individuals with alcohol dependence syndrome (PWADS) during the COVID-19 pandemic. Materials and Methods: This cross-sectional institutional-based study collected data from 50 participants using the consecutive sampling method. The following tools were utilized: Socio-demographic Questionnaire, Domestic Violence Questionnaire, the Kessler Psychological Distress Scale, and the Brief Cope. Results: The mean age of the spouses (PWADS) was 42 ± 8.20 years, with 42% (N = 21) being skilled workers. Sixty percent (N = 30) had been consuming alcohol for the past 10 years, and 50% (N = 25) had been undergoing treatment for 2-5 years. Among the study participants (wives of PWADS), the mean age was 40.70 ± 8.70 years, and 82% were housewives. They reported a significant increase in alcohol use and excessive spending by their husbands, which negatively affected the home environment. Domestic violence, in terms of psychological, physical, and sexual abuse, also significantly increased (p < .001) compared to before and during the lockdown. Forty-eight percent of the wives reported experiencing severe levels of psychological distress. They employed various coping strategies. Conclusion: The lived experiences of wives of individuals with alcohol dependence syndrome during the COVID-19 pandemic were challenging, as their husbands not only continued their regular alcohol consumption but also increased the amount and expenditure on alcohol. This had a detrimental effect on the home environment, worse than the situation before the lockdown. Targeted interventions are necessary to address these issues during the COVID-19 pandemic or similar situations.

Mental and Behavioural Disorders of Childhood and Adolescence: An Observational Study.

BACKGROUND: There is overlap of symptoms in psychiatric disorders, especially in mental and behavioural disorders of childhood and adolescence. Half of all lifetime psychiatric disorders tend to arise by age 14 years and three fourths of them arise by age 24 years. AIM: To study the various types of mental and behavioural disorders of childhood and adolescence, and to find out comorbidities within and across the types. METHODS: An observational cross-sectional study was carried out over a period of one year in the psychiatry department of a tertiary care general hospital. The psychiatric diagnoses according to the World Health Organization's (WHO) tenth revision of the International Statistical Classification of Health and Related Problems (ICD-10) were categorised into type 1 (depression, anxiety, obsessive-compulsive disorder, and somatoform disorder), type 2 (attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder), type 3 (mental retardation, developmental disorders of speech and language, and scholastic skills, and pervasive developmental disorders). Descriptive statistics was used with frequency and percentage. RESULTS: Total sample size was 137. Children and adolescents were almost equally distributed. Boys were more than girls. Type 3 disorders were maximum. Adolescents had mostly type 1 disorders. Children had mostly type 3 disorders. Girls had almost same number of type 1 and type 3 disorders. Boys had mostly type 3 disorders. Within group comorbidity was mostly with type 3 disorders. Across group comorbidity was highest in type2-type 3 disorders. CONCLUSION: Mental and behavioural disorders in childhood and adolescence do vary according to age and sex, and their recognition will help in the early diagnosis and proper management.

Relationship between Toxoplasma Gondii and Psychotic Disorders with Implications toward a Brain-based Diagnostic System and Novel Treatment Approaches: A Study Protocol.

What role infectious agents play in the causation of psychotic disorders? To investigate this area, we have aimed to investigate the relationship between Toxoplasma gondii and psychotic disorders. A hospital-based cross-sectional study is designed. IgM and IgG antibodies to T. gondii in patients with psychotic disorders will be measured and presented in result. Seropositivity rates will be compared with first-degree relatives and healthy volunteers. Also, types of psychotic disorders and seropositivity rate will be compared. Here, we are presenting the study protocol with implications toward a brain-based diagnostic system and novel treatment approaches.

Mental health professionals as 'silent frontline healthcare workers': perspectives from three South Asian countries.

Mental health professionals across the globe foresaw the mental health impact of the coronavirus disease 2019 (COVID-19) pandemic. They have faced scarcity of trained professionals, rising morbidities, lack of protective gear, shortage of psychotropic drugs, and poor rapport building due to masking and social distancing. Amidst all, they have responded with approaches that focus on continuing mental health services to the patients already in care, education of the vulnerable people to help them cope with these stressors, and provide counselling services to patients and families affected by the pandemic.

Assessing burden and its determinants in caregivers of chronic kidney disease patients undergoing haemodialysis.

Background: Caregivers face a lot of adversities while supporting their near ones undergoing haemodialysis, and their burden is often ignored by health professionals. The paucity of research in the Indian context has kept their needs out of sight. Aim: To explore the level of burden in the caregivers of patients with chronic kidney disease (CKD) undergoing haemodialysis and to assess whether patient related variable affects the burden. Methods: Fifty-one patients and their caregivers from two dialysis units in Sikkim, India, were assessed cross-sectionally. The Zarit Caregiver Burden Scale (ZCBS) was administered to measure the caregiver burden. The Patient Health Questionnaire-9 (PHQ-9) and the Charlson's Comorbidity Index (CCI) assessed the patient's depression and medical comorbidities, respectively. Descriptive analysis was done for the sociodemographic and clinical variables. Chi-square test was used to find the association between the categorical data. Kruskal-Wallis tested the association between categorical and quantitative variables. Results: Mean age of patient was 46.13 (±13.15) years and that of the caregiver was 44.78 (±12.14) years. 68.6% of caregivers had mild to severe levels of caregiver burden. Caregivers who were unemployed and educated till secondary school were more likely to report caregiver burden. Female gender, older caregivers, and caregivers attending patients with a longer history of haemodialysis reported a more severe burden. Conclusion: The level of burden in caregivers of CKD patients is significant and is affected by various factors, which, in turn, also affects patient's wellbeing. Further research in this area is needed in our country for better management of patients and policymaking.

The psychological impact of the COVID-19 pandemic and associated risk factors during the initial stage among the general population in India.

BACKGROUND: In the absence of treatment and unclear prognosis, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) itself, and public health measures like lockdown enforced by the government to limit the spread of the virus poses a threat to the psychological health of the general population. AIM: To assess the psychological status of the Indian population during the initial phase of lockdown. METHOD: It was a cross-sectional online survey where the questionnaire was disbursed by snowballing. The link to the survey was shared in different social networking platforms between 6th and 22nd of April 2020. The questionnaire collected responses related to the sociodemographic variables, exposure history, precautionary measures used, and the Depression, Anxiety, and Stress Scale (DASS-21) score. RESULTS: A total of 541 participants responded to the questionnaire. Only 422 respondents' responses from 23 states of India who completed the questionnaire were included for assessment. The mean age of the participants was 30.5 (SD=10.9) years. Female constituted 60.4% (n=255) of the respondents. The pre-existing medical illness that the respondents had were diabetes mellitus, four per cent (n=17), hypertension, five per cent (n=21), thyroid dysfunction, nine per cent (n=38), and mental illness, five per cent (n=21). The median (IQR) of the DASS-21 item scale was found to be 16 (4-32). The percentage of the respondents who reported stress was 35.5% (n=149), anxiety, 32% (n=135), and depression, 34.7% (n=146). Respondents with sociodemographic variables like being single, student status, competed education till graduation, homemakers, working in public sector, and history of mental illness were more likely to experience stress, anxiety, and depression. A majority of the respondents were practicing hand hygiene and social distancing. Respondents who were unaware of their exposure status were more likely to have depression. CONCLUSION: The Indian population is experiencing the psychological impact of the coronavirus disease 2019 (COVID-19), which may increase with the spread of the infection. India needs to gear up to face mental health consequences. People with a pre-existing physical and psychological illness needs extra care and precaution to prevent any relapse or development of complications.

A novel approach to address the novel threat.

The editorial highlights the mental health initiative of the Government of Assam, India through the Monon: Assam Cares programme to deal with the coronavirus disease 2019 (COVID-19) pandemic. Through this initiative, trained mental health professionals proactively reached to people with COVID-19 to provide psychological aid.

Profile of distress callers and service utilisation of tele-counselling among the population of Assam, India: an exploratory study during COVID-19.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has affected people globally by causing psychological, social, and economic chaos. The Assam Police, India started telephone helplines to address the psychological issues. AIMS: To evaluate the sociodemographic profile of the distress callers, their psychosocial concerns, the interventions provided by the service provider, and whether the service users were satisfied with the intervention(s) or not. METHOD: It was a cross-sectional study done during the period of lockdown (7-24 April 2020). All the callers who called the helpline were screened for anxiety, depression, suicidal thoughts (when required), and the psychosocial issues which they were facing were explored. They were provided the psychological intervention(s) at the appropriate time, and they were asked to rate their experience at the end. RESULTS: A total of 239 callers used the tele-counselling services. The majority of callers were male (79.1%). Most of the callers were between 19-35 years of age group (66.5%), married (52.5%), and graduates (31%). Two-thirds of the callers called to seek guidance for their own issues and one-third for their relatives or friends. Callers had anxiety (46%), depressive disorder (8.3%), and depressive symptoms not qualifying for depressive disorder (14%), and suicidal thoughts (5.44%). The commonest intervention provided to the callers was supportive (77.8%), followed by psychoeducation (30.5%), cognitive behaviour therapy (24.7%), relaxation (23.6%) and behaviour therapy (13.4%). Most of the callers utilised more than one type of therapy. Overall, most of the callers were satisfied and appreciated the tele-counselling services. CONCLUSION: The findings could help in formulating psychological interventions to improve the mental health of vulnerable groups in the post-COVID-19 period to reduce psychiatric morbidity and mortality.