Family intervention for expressed emotion in schizophrenia: Indian context.

Background: Expressed emotion (EE) being a part of the family environment could adversely affect the course and prognosis of schizophrenia. Aim: This study aimed to assess the effects of family intervention among the caregivers of persons with schizophrenia. Methods and Materials: The experimental research design was used for 80 caregivers of persons with schizophrenia. Sociodemographic interview schedule of caregivers, family emotional involvement and criticism scale, and mini international neuropsychiatric interview (MINI 6.0) were used for data collection. A standardized family intervention program involving 10 sessions was provided to caregivers. The intervention included six sessions of family psychoeducation, two sessions of communication training, one session of stress management, and one session on recap and referral services over a period of 2-3 months. The intervention used methods of social case and group work, social work principles, and therapeutic activities. The methodologies adopted a brainstorming technique, case vignettes, role plays, and video clippings concerning the topics of the day. Brief handout on intervention was given. Results: The RMANOVA score (F = 35.892; P =0.001) revealed that there was a significant reduction in EE of the caregivers of the intervention group who underwent the family intervention program in comparison with the control group. Conclusion: Family-based intervention was found to be effective for reducing EE in schizophrenia.

Gaming among female adolescents: profiling and psychopathological characteristics in the Indian context.

Objectives: Gaming is a predominant leisure time activity among adolescents, and the literature suggests that unrestrained gaming behavior might lead to gaming disorder. ICD-11 and DSM-5 have recognized gaming disorder as a psychiatric condition and grouped it under the behavioral addiction category. Research on gaming behavior and addiction is largely based on data from the male population, and problematic gaming has largely been understood from the male perspective. In this study, we are attempting to bridge the existing lacuna in the literature by exploring gaming behavior, gaming disorder, and its related psychopathological characteristics among female adolescents in India. Methods: The study was conducted on a sample of 707 female adolescent participants who were contacted through schools and academic institutes in a city in Southern India. The study adopted a cross-sectional survey design, and data were administered using the mixed modality of online and offline data collection. The participants filled out the following set of questionnaires: socio-demographic sheet, Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), Strength and Difficulties Questionnaire (SDQ), Rosenberg self-esteem scale, and Brief sensation-seeking scale (BSSS-8). The data gathered from the participants were then statistically analyzed using SPSS software version 26. Results: The descriptive statistics revealed that 0.8% of the sample (i.e., five participants out of 707) obtained scores meeting gaming addiction criteria. Correlation analysis demonstrated a significant relationship between all the psychological variables with total IGD scale scores (p < 0.05). Total SDQ, total BSSS-8, and domain scores of SDQ, such as emotional symptoms, conduct, hyperactivity, and peer problems, were positively correlated, whereas total Rosenberg scores and domain scores of prosocial behaviors of SDQ were negatively correlated. The Mann-Whitney U-test was employed to compare "with gaming disorder" and "without gaming disorder" categories of female participants. Comparing these two groups revealed significant differences in emotional symptoms, conduct, hyperactivity/inattention, peer problem, and self-esteem scale scores. Furthermore, quantile regression was computed, showing that conduct, peer problem, and self-esteem displayed trend-level prediction for gaming disorder. Conclusion: Female adolescents prone to gaming addiction can be identified through psychopathological characteristics of conduct, peer problem, and low self-esteem. This understanding can be useful in developing a theoretical model focusing on early screening and preventive strategies for at-risk female adolescents.

Affective symptoms as a predictor of internet addiction among young adults.

Objectives: Mental health difficulties have been found to be associated with internet addiction, which makes it a multifaceted problem. The current study aimed to examine the relationship between internet addiction and affective states (depression, anxiety, and stress). Material and Methods: The study sample consisted of 731 individuals (403 males and 328 females) ranging in age from 18 to 25 years. We used an observational survey design to study participants with an internet addiction test and depression, anxiety, and stress scale. Results: The mean age ± standard deviation of the sample was 22.58 ± 2.80 years. Stress and depression were found to play a major role in internet addiction in the regression analysis. Conclusions: The study supports the association between internet use and stress and depression. The findings imply the need for early identification and intervention of affective states in the context of unhealthy internet use.

Effectiveness of multimodal psychotherapeutic intervention for internet gaming disorder.

BACKGROUND: Large number of studies on Internet gaming disorder (IGD) have primarily focused on ascertaining its psychological correlates. Few studies have focused on developing and assessing effectiveness of multimodal psychotherapeutic intervention programs. This intervention focused on minimizing salience, pre-occupation, conflict related to gaming and enhancing the overall quality of life, inclusive of psychological health, physical health, and environmental problems in individuals with IGD. At present, there appear to be no such studies in the Indian context. METHODS: In this study, we developed and assessed the effectiveness of an intervention manual for IGD. The intervention program consisted of ten 60-minutes sessions with one therapist administering sessions once in each week. The interventions included motivational enhancement strategies, cognitive restructuring, behavioral strategies and relapse prevention. The outcomes from intervention were measured in terms of improvement in IGD, IAT, and overall quality of life. Our assessments, both at baseline and post-intervention consisted of Internet Addiction Test (IAT), Internet Gaming Disorder Test (IGD-20) and the Whoqol-Bref. A total sample of 40 was selected out of which 33 individuals completed the 10 sessions of multimodal psychotherapy program and post assessments. RESULTS: A total of 40 participants (age: M = 20.25, SD = 5.39) enrolled, out of which 33 completed the entire intervention program of 10 sessions and showed significant improvements. The IAT and IGD-20 showed significant difference in the scores for before treatment (M = 52.88, SD = 16.25) and after treatment (M = 42.87, SD = 11.31; t (32) = 5.10, p = 0.000) conditions; and right before treatment (M = 56.88, SD = 19.25) and after treatment (M = 47.87, SD = 15.31; t (32) = 6.94, p = 0.000) conditions respectively. The internet addiction and internet gaming disorder scores showed a similar degree of severity reductions on the IAT and IGD-20 respectively at the end of week 8. In addition, the participants showed significant improvements in the quality of life inclusive of physical and psychological health post the completion of intervention program. LIMITATIONS: The sample size of the study was small and assessments for evaluation of other psychological symptoms like depression, anxiety could have been conducted. CONCLUSION: The intervention program indicated a substantial change in the IGD scores at post- assessment. A study on a larger sample to assess the validity of the manualized multimodal psychotherapy program for IGD needs to be conducted. In addition, this manualized intervention program can be useful for administering structured intervention for IGD by mental health professionals working in the area of internet gaming disorder.

Effectiveness of a Module Based Training on Nurses' Attitude Towards Social Norms and Beliefs That Support Abuse Among women with Mental Illness.

Violence against women is a priority public health issue. Women with mental illness are at a double disadvantage. While social norms and beliefs either support or confront violence against women, research is limited on this issue. A randomized controlled design was adopted for the present study. This study was aimed to evaluate the effectiveness of module-based training in changing nurses' attitudes towards norms and beliefs that support violence against women in mental health care settings. In this study, 68 nurses were randomly assigned to either the experimental or control group (34 in each group). After receiving the training program, the mean scores on norms and beliefs and justifiability of abuse scales were significantly higher in the experimental group compared to the control group (p < 0.05). The results confirmed the positive impact of the training program in changing nurses' attitudes. However, further studies are required to draw firm conclusions on the effectiveness of the training intervention.

Does mild internet use augment cognitive functions?: Preliminary evidence.

BACKGROUND: Internet usage leads to psychological disturbances, social problems, and neuropsychological dysfunctions. Alhough there is no definite trend has been reported for the association of augmentation of cognitive function and internet use pattern. METHOD: The current work explored the neuropsychological profile among healthy, mild, and moderate users of internet in the age group of 18 to 30 years. Sixty subjects (20 healthy internet users, 20 mild internet users, and 20 moderate internet users) were screened for internet usage using internet addiction test. Background datasheet, NIMHANS comprehensive battery of neuropsychological tests, and Wechsler memory scale III (Indian adaptation) were administered in an individual setting. RESULTS: It revealed that mild users have performed relatively better than healthy normal controls on mental speed, sustained attention, cognitive switch, and interference scores on Stroop test. CONCLUSIONS: It has implication for evolving psychological intervention for promotion of mild internet use for the promotion neuropsychological functioning as well as physicians at primary setting can educate users about benefits of mild use of the internet and other technology devices. It will help in the promotion of healthy use of technology.

Healthy lifestyle behavior and personal control in people with schizophrenia with healthy controls: A cross-sectional comparative study.

The aim of the article was to compare persons with schizophrenia and healthy controls about their life style on their physical health and personal control. Evidences highlights that it helps to change risk behaviours associated with co morbid physical health problems. Subjects were recruited from adult mental health services in tertiary level psychiatric center.Comparisons between the groups were done by using the lifestyle and personal control questionnaire. Subjects were 86 with schizophrenia, 72 were healthy controls. Results showed significant difference. However, physical health was considered to be a less important priority in their personal life by persons with schizophrenia.

Internal migrants' experiences with and perceptions of frontline health workers: A nationwide study in 13 Indian cities.

The role of frontline health workers is crucial in strengthening primary health care in India. This paper reports on the extent of services provided by frontline health workers in migrants' experiences and perceptions of these services in 13 Indian cities. Cluster random sampling was used to sample 51 055 households for a quantitative survey through interviewer-administered questionnaires. Information was sought on the receipt of health workers' services for general health care overall (from the head/other adult member of the household) and maternal and immunization services in particular (from mothers of children <2 years old). Purposively, 240 key informants and 290 recently delivered mothers were selected for qualitative interviews. Only 31% of the total respondents were aware of the visits of frontline health workers, and 20% of households reported visits to their locality during past month. In 4 cities, approximately 90% of households never saw health workers in their locality. Only 20% of women and 22% of children received antenatal care and vaccination cards from frontline health workers. Qualitative data confirm that the frontline health workers' visits were not regular and that health workers limited their services to antenatal care and childhood immunization. It was further noted that health workers saw the migrants as"outsiders." These findings warrant developing migrant-specific health-care services that consider their vulnerability and living conditions. The present study has implications for India's National Urban Health Mission, which envisions addressing the health care needs of the urban population with a focus on the urban poor.

Internet addiction at workplace and it implication for workers life style: Exploration from Southern India.

BACKGROUND: Industries are focusing on digitization of their working environment. It helps in enhanced productivity as well as communication among workers. It also lead to higher usages of internet for non work related use at workplace. It affect their productivity at workplace. The present study was undertaken to explore internet use in Information technology (IT) industry and non IT industry, to see its consequence and effect on lifestyle and functioning. METHODS AND MATERIALS: 250 employees of various Government/Private sector organizations(using internet for more than a year and education level of graduation and above) were approached for the assessment using cross sectional research design. RESULTS: The average age of participants was 30.4 years. 9.2% participants falling in category of occasional problems/'at risk' for developing addiction in functioning/moderate impairment due to internet use. Statistically more participants falling in 'at risk category' had reported postponement of work and change in productivity. Sleep, meals, personal hygiene and family time were postponed more by participants who were at risk for developing internet addiction. CONCLUSIONS: The study has implications for developing a workplace based psycho-social intervention program to address the technology use issues at workplace.

Insights into the crystal structure of BRD2-BD2 - phenanthridinone complex and theoretical studies on phenanthridinone analogs.

Bromodomain and extra-terminal family proteins recognize the acetylated histone code on chromatin and participate in downstream processes like DNA replication, modification, and repair. As part of epigenetic approaches, BRD2 and BRD4 were identified as putative targets, for the management of chronic diseases. We have recently reported the discovery of a new scaffold of the phenanthridinone-based inhibitor (L10) of the second bromodomain of BRD2 (BRD2-BD2). Here, we present the crystal structure of the BRD2-BD2, refined to 1.4 Å resolution, in complex with ß-mercaptoethanol (a component of the protein buffer). The ß-mercaptoethanol covalently links to C425 of BD2 in the acetyl-lysine binding pocket, to form a modified cysteine mercaptoethanol (CME). The CME modification significantly hinders the entry of ligands into the BD2 binding pocket, suggesting that ß-mercaptoethanol should be removed during protein production process. Next, to confirm whether phenanthridionone scaffold is a new inhibitor family of BRD2-BD2, we have determined the crystal structure of BD2 in complex with 6(5H)-Phenanthridinone (a core moiety of L10), refined to 1.28 Å resolution. It confirmed that the phenanthridinone molecule, unambiguously, binds to BD2. Moreover, we performed molecular docking and molecular dynamic studies on selected phenanthridinone analogs. The predicted L10 analogs are stable with essential hydrophobic and hydrophilic interactions with BD2 during molecular dynamic simulations. We propose that the predicted phenanthridinone analogs may be potential molecules for inhibiting the BD2 function of acetylated histone recognition.

Tuberculosis prevalence and socio-economic differentials in the slums of four metropolitan cities of India.

AIM: To understand tuberculosis (TB) prevalence among the slum dwellers of metropolitan cities of India and the factors associated with TB prevalence. METHODS: National Family Health Survey-III data for four metropolitan cities namely, Delhi, Mumbai, Kolkata and Chennai was used for this study. RESULTS: Prevalence of TB is significantly (P=0.001) higher in the slums than non-slums of Mumbai, Chennai and Kolkata cities. As the living standard increases, TB prevalence decreases. Logistic regression analysis uncovers that lower standard of living is highly associated with TB followed by place of residence (slum or non-slum). CONCLUSION: Mumbai has the highest prevalence among the four cities studied herein. Living standards, place of residence and absence of windows and electricity in the households are the factors associated with TB prevalence.

On somatic symptoms measurement: the scale for assessment of somatic symptoms revisited.

BACKGROUND: Scale for assessment of somatic symptoms (SASS) has been widely used for assessing somatic complaints since many years. With impending changes in the classificatory system on somatoform disorders, we re- assessed the test-retest reliability and inter-rater reliability of SASS. MATERIALS AND METHODS: SASS was administered twice with a gap of 24 h on 20 subjects for test retest reliability. Two clinicians assessed inter-rater reliability on 20 subjects. Kendall tau B and Cronbach's alpha were calculated from the data. RESULTS: All of the items except burning sensation, weakness of mind and trembling had strong correlation with values >±0.40 on both test retest and inter-rater reliability; burning sensation and trembling were not reported by any subject. On inter-rater reliability the items constipation, diarrhea, lack of libido weren't scored by any subjects. Cronbach's alpha for test retest was 0.982 and 0.840 indicating good internal consistency. CONCLUSION: Majority of the symptoms in SASS had high correlation in both test retest reliability as well as inter-rater reliability, however few items needs revision.

Prevalence and psychosocial factors of aggression among youth.

BACKGROUND: Youth indulgence themselves in various aggressive behaviors leading to significant psychosocial dysfunctions. The present study assesses the prevalence of aggression among youth and to assess the risk factors of aggression among youth. MATERIALS AND METHODS: Anger Data sheet, Resilience Scale and Buss-Perry Aggression Scale, were administered on 5476 participants using survey design. Data was collected from different communities (college, residential, apartments and workplace) of Bangalore, Jammu, Indore, Kerala, Rajasthan, Sikkim and Delhi. 47% were female and 53% were male. The mean age of the sample was 20.2 years. Comparative analysis was carried out by Pearson correlation coefficient and Chi-square was also carried out. RESULTS: About 17.7% of the youth has high mean aggression score on Buss-Perry Aggression Scale. Males have high mean score on aggression than females. Males experienced more verbal aggression, physical aggression and anger than females. Younger age group (16-19 years) experienced more aggression than older age group (20-26 years). The risk factors of the youth aggressions were identified as physical abuse in childhood, substance abuse such as alcohol and tobacco, negative peer influence, family violence, academic disturbance, psychological problems attention deficit-hyperactivity disorder, suspicious, loneliness, mood disturbance, negative childhood experience and TV and media. CONCLUSION: The study document, the presence of correlates of risk factors of aggression among youth and implies usages of management strategies to help them to handle aggression.

Clinical validity of NIMHANS neuropsychological battery for elderly: A preliminary report.

BACKGROUND: Neuropsychological assessment plays a crucial role in the assessment of cognitive decline in older age. In India, there is a dearth of culturally appropriate standardized measure to assess cognitive functions in early dementia. The aim of the study was to examine clinical validity of NIMHANS Neuropsychological Battery for Elderly (NNB-E) in identifying early dementia. OBJECTIVES: To examine validity (discriminant and concurrent) of NIMHANS Neuropsychological Battery for Elderly (NNB-E). RESULTS: Participants with AD showed significantly poorer performance on every test including memory and non-memory domains. However, tests of episodic and semantic memory were particularly sensitive in discriminating between normal and AD groups. Further scores on various subtests in the NNB-E were positively associated with scores on HMSE and negatively associated with Clinical Dementia Rating and Everyday Abilities Scale for India (EASI) scores. CONCLUSIONS: NNB-E was able to differentiate normal controls from AD patients, and it can therefore be an ecologically valid tool for Indian older adults.