ABSTRACT
Background: The proportion of the elderly population is increasing in low and middle-income countries. Apart from systemic illnesses, elderly people face mental illnesses. Effect of group reminiscence therapy in reducing some of the mental health aspects showing a promising effect but the evidence is lacking in Indian settings. The present study aimed to determine the effect of reminiscence therapy in decreasing the level of loneliness, depressive symptoms, and anxiety among the elderly population at an institutional level.Methods: In this quasi-experimental study, residents of an old age home were evaluated for loneliness, depressive symptoms and anxiety through revised UCLA, geriatric depression scale, and Geriatric Anxiety Scale respectively. Group reminiscence therapy was applied to them and post-intervention assessment was done by the same scales.Results: Significant reduction of anxiety score [1.33 (0.03, 2.64)] was noticed in anxiety. Depressive symptoms showed a mean reduction in score [0.59 (-0.41, 1.6)] but statistically not significant. When graded into severity, all three outcomes showed improvement from higher severity grade to lower grade in post-intervention assessment. The intervention resulted in an improvement of 66.7% in depressive symptoms, 33.3% in anxiety and 30.8% in loneliness.Conclusions: The study found reminiscence therapy could be encouraging in resource-poor Indian settings. We recommend for further exploration of the long-term effects of this program, its feasibility, cost-effectiveness, and validation of the content for large-scale implementation.
ABSTRACT
Background & objectives: Genetic factors have potential of predicting response to antidepressants in patients with major depressive disorder (MDD). In this study, an attempt was made to find an association between response to escitalopram in patients with MDD, and serotonin transporter (SLC6A4) and receptor (5HTR1A, 5HTR2A) polymorphisms. Methods: Fifty five patients diagnosed as suffering from MDD, were selected for the study. The patients were treated with escitalopram over a period of 6-8 wk. Severity of depression, response to treatment and side effects were assessed using standardised instruments. Genetic variations from HTR1A (rs6295), HTR2A (rs6311 and rs6313) and SLC6A4 (44 base-pair insertion/deletion at 5-HTTLPR) were genotyped. The genetic data of the responders and non-responders were compared to assess the role of genetic variants in therapeutic outcome. Results: Thirty six (65.5%) patients responded to treatment, and 19 (34.5%) had complete remission. No association was observed for genotype and allelic frequencies of single nucleotide polymorphisms (SNPs) among remitter/non-remitter and responder/non-responder groups, and six most common side-effects, except memory loss which was significantly associated with rs6311 (p=0.03). Interpretation & conclusions: No significant association was found between the SNPs analysed and response to escitalopram in patients with MDD though a significant association was seen between the side effect of memory loss and rs6311. Studies with larger sample are required to find out genetic basis of antidepressant response in Indian patients.