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The prevalence of cannabis use disorders has become a noteworthy global public health issue. Understanding the neurobiological factors associated with cannabis use disorder (CUD) is crucial for creating effective interventions. One such factor, the brain-derived neurotrophic factor (BDNF), has been linked to the onset and persistence of addictive behaviors. This systematic review aims to summarize the existing literature on BDNF levels in individuals with CUD to provide a comprehensive overview of the current evidence. A systematic search was conducted using electronic databases (PubMed, Scopus) for relevant studies. The search approach yielded a total of 785 articles, with 559 located in the PubMed database and 226 in Scopus. Studies reporting BDNF levels in individuals with CUD compared to healthy controls were included in this study. Ultimately, eight articles were included in this systematic review. The primary emphasis of these studies was on individuals who were cannabis users or had a dependency on cannabis. There is considerable variation in the estimated effect size among included studies due to heterogeneity; hence, a random effect model was used for meta-analysis. The findings of our study suggest that the effect size of BDNF levels was 0.25 with 95% CI (-0.55; 1.05) in cannabis users, which was not statistically significant (p-value=0.54). Therefore, it is important to interpret the results with caution, and additional research is warranted to investigate the potential factors contributing to this heterogeneity.
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Hypochondriasis is a condition characterized by an unrealistic fear of having a serious medical illness resulting in health anxiety. Currently, no evidence-based pharmacological treatment options are available for the treatment of hypochondriasis. Since selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment option for anxiety disorders, they may be useful for relieving hypochondriasis symptoms. Moreover, off-label use of SSRIs in these cases is highly prevalent in clinical practice. Thus, in this study, we aimed to review the available literature to assess the role of SSRIs in the treatment of hypochondriacal symptoms. A systematic search was conducted in PubMed, Scopus, ScienceDirect, Embase, and Cochrane Database of Systematic Reviews from the date of inception to December 2022. We included only randomized clinical trials (RCTs) investigating the effect of SSRIs in the treatment of hypochondriacal symptoms. Non-RCTs, observation studies, and animal studies were excluded. The Risk of Bias 2 tool was used to assess the quality of included studies. Out of 2264 articles, six RCTs met our inclusion criteria. Studies have been conducted using different SSRIs in the treatment of primary hypochondriasis and hypochondriacal symptoms associated with other psychiatric disorders. All the studies have found that the use of SSRIs has some beneficial role in improving hypochondriacal symptoms. This suggests that SSRIs may be one of the promising pharmacological interventions in the treatment of hypochondriasis.
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Background: High levels of stress among pregnant women have been reported during the coronavirus disease 2019 (COVID-19) pandemic because of various infection-related and lockdown measures. Concerns about safe delivery, breastfeeding, and child care may increase the risk of depression in vulnerable women during the perinatal period. Aim: To study the perceptions regarding child care and prevalence of perinatal depression during the COVID-19 pandemic. Materials and Methods: A cross-sectional community-based survey was conducted among 750 lactating mothers post delivery between September 2020 and February 2021 in 51 districts of Uttar Pradesh. A convenient purposive sampling technique was used. A semi-structured questionnaire was used to collect the socio-demographic details and perceptions regarding child care during the COVID-19 pandemic. Assessment of depression symptoms was performed with the help of patient health questionnaire 9 (PHQ-9). Results: A total of 440 participants were suffering from some form of depression symptoms; the majority had mild depression. Depression was found to be higher among homemakers and young mothers (age <25 years). Depression was found in more than 40% of the respondents who felt fear of COVID infection during breast feeding and hospital stay. Similarly, more than 50% of the respondents who feared unavailability of timely health services and social ignorance had depression. More than 60% of the mothers who did not have any knowledge about safe breast-feeding and child care practices had some form of depression, and the results were statistically significant. Conclusions: Perinatal depression is highly prevalent during the ongoing pandemic. Hence, regular screening, psychoeducation, awareness regarding safe breast feeding, and child care practices are recommended.
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Introduction The link between sleep and cognitive processes, such as memory and learning, continues to be one of the most intriguing and perplexing theories. Undergraduate medical students in their first year are particularly vulnerable to sleep disturbances. Academic achievement and learning have been linked to sleep patterns, which include not only the quantity and quality of sleep but also the timing of sleep in relation to the natural sleep onsets, or chronotypes. There have been conflicting reports on the outcomes of sleep and relatively fewer researches focused on the impact of chronotypes on learning and academic achievement among medical students. The current study thus sought to determine the chronotypes of medical students, evaluate the quantity and quality of sleep, and determine the impact of these factors on learning and academic performance. Methods The study was conducted in the Department of Physiology, All India Institute of Medical Sciences (AIIMS) Gorakhpur, India. Sleep health was assessed in 167 first-year medical students using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), morningness-eveningness questionnaire (MEQ), and sleep log books. Learning and memory assessment was performed using Raven's progressive matrices test. Grade point average (GPA) was used to assess their academic performance. The relationship of sleep scores with GPA and RPM scores were obtained by linear regression analysis. One-way analysis of variance (ANOVA) and unpaired t-test were used to investigate other comparisons among categories of chronotypes and those of mean GPA. A p-value of <0.05 was considered as significant. Results The mean GPA and RPM scores obtained in the groups with PSQI ≥ 5 (2.67 ± 1.1, 49.51 ± 6.24, respectively) and PSQI < 5 (3.15 ± 0.59, 54.73 ± 4.01, respectively) and those in the group with ESS ≥ 10 (2.72 ± 1.17, 50.97 ± 5.92, respectively) and ESS < 10 (3.15 ± 0.6, 54.18 ± 3.91, respectively) varied with statistically significant differences (p < 0.05). Statistically significant R-squared values for the relationship of PSQI and ESS scores with RPM and GPA scores were obtained. No correlation between academic grades and chronotype was found. Poor GPA scores were found to be associated with reduced mean sleep duration for one week before the exams. Conclusion Learning and academic performance are negatively impacted by poor sleep quality and daytime sleep dysfunction. No definite evidence for the association of sleep chronotypes with the learning and memory could be attained. Higher test performance is more closely linked to the average sleep length over a duration of time preceding the exams.
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Recent evidence links melatonin hormone and its receptor to the etiology and behavioral manifestation of addiction. The role of exogenous melatonin in addiction treatment is still inconsistent and unclear. The present study aimed to review the literature on randomized clinical trials that evaluated the role of melatonin supplementation, compared to placebo, in the treatment of various substance addictions. The literature searches of relevant articles published in the English language in MEDLINE and Google Scholar databases were performed from inception up to May 2021. We included only randomized clinical trials investigating the effect of melatonin treatment, compared to placebo, on substance addiction-related parameters. Non-randomized clinical trials, observation studies, and animal studies were excluded. The risk of bias-2 was used to assess the quality of the studies. Of 537 articles, 12 randomized control trials (RCT) met our inclusion criteria. Studies have been conducted on substances of addiction including benzodiazepine (BZD), alcohol, nicotine, and opioids. Our results indicated that melatonin treatment had mixed results in improving sleep quality and was not found beneficial in BDZ cessation/discontinuation rate among patients with BDZ dependence. Sleep quality and mental health had improved by melatonin supplements in opioid addiction. In nicotine addiction, melatonin treatment showed effectiveness only on mood changes but not in performance tests. In patients with alcohol use disorder (AUD), melatonin treatment did not show any improvement in sleep quality. We found that the use of exogenous melatonin in substance addiction has mixed results which do not provide sufficient evidence, relative to randomized clinical trials, to establish its role.
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It has long been debated whether bowel and bladder anxiety are a part of obsessive compulsive spectrum disorder or a variant of agoraphobia with no consensus view yet. Tricyclic antidepressants are reportedly efficacious in such cases and lead to complete resolution of symptoms. Here, we report a 36-year-old male having urges to visit toilet when in public places or where toilets are not easily available and a resulting avoidance of such spaces fearing an episode of incontinence. Symptoms originated 16 years ago when he was in university which compelled him to drop out. We treated him with paroxetine and relaxation therapy to which he responded satisfactorily.
