Central institute of Psychiatry is an institute that is directly governed by the Government of India. It is situated in Kanke, Ranchi in Jharkhand state of India.
Background:Depressive and anxiety disorders, together contribute to over 50% of the Disability-Adjusted Life Years (DALYs). While outcomes for severe mental illnesses have been extensively studied, outcome-based research on CMDs remains limited. Aim:To evaluate the needs, barriers, caregiver involvement, recovery and service satisfaction of patients with CMDs as a measure of service outcome. Methods:This prospective cohort study included 274 patients with CMDs diagnosed per ICD-10 criteria. Participants were assessed at baseline and six months using researcher-rated and service user-rated outcome measures. Instruments included the Camberwell Assessment of Needs-Research (CAN-R), Client Satisfaction Questionnaire (CSQ), Barriers to Access to Care Evaluation (BACE v3), Involvement Evaluation Questionnaire (IEQ), and Importance of Services in Recovery (INSPIRE). Generalized Linear Mixed Models (GLMM) and negative binomial regression were employed to analyze outcomes over time. Results:At baseline, 90.9% of participants had needs, with unmet needs comprising 80.7%. Major unmet needs were psychological distress (73.4%), looking after the home (57.7%), and daytime activities (50.7%). Depression had the highest impact on unmet needs, contributing to a 32% increase per unit rise in depression severity (IRR = 1.318, P < 0.001). Stigma accounted for only about one-fifth of the total perceived barriers to accessing care, with worrying and urging behaviors among the caregivers. At the end of six months, the unmet needs significantly improved, but caregivers were still concerned about the well-being of the participants, associated with improvements in service satisfaction. Conclusions:CMD patients had significant unmet needs, especially for psychological distress, household, and daily activities. Depression was the largest contributor to unmet needs, while panic and somatic disorders were lower. Caregiver burden evolved, and non-stigma-related barriers to care were significant.
BACKGROUND:Negative symptoms in schizophrenia are associated with long-term disability and poor functional outcomes. These symptoms remain inadequately addressed by current pharmacological and psychosocial interventions. Neuromodulation strategies, such as combining transcranial magnetic stimulation and transcranial direct current stimulation, are emerging as promising noninvasive options. OBJECTIVES:This study aimed to assess the efficacy and safety of combining cathodal high-definition transcranial direct current stimulation with intermittent theta burst stimulation for reducing negative symptoms in patients with schizophrenia. MATERIALS AND METHODS:In this randomized, double-blind, sham-controlled trial, 40 inpatients diagnosed with schizophrenia with predominantly negative symptoms were assigned to receive either active or sham priming with high-definition transcranial direct current stimulation followed by intermittent theta burst stimulation. Treatment was delivered twice daily over 2 weeks. Clinical assessments were conducted at baseline, after 2 and 4 weeks, using standard rating scales for symptom severity (PANSS, SANS) and global functioning. RESULTS:Both active and sham groups showed significant within-group improvement in overall symptom scores over time. The active stimulation group demonstrated significantly greater reductions in total and attention-related negative symptom scores. Improvements were also observed in cognitive and depressive domains. The treatment was well tolerated, with only mild and transient side effects reported. CONCLUSIONS:Priming intermittent theta burst stimulation with high-definition transcranial direct current stimulation appears to be a safe and potentially effective approach for targeting negative symptoms in schizophrenia.
OBJECTIVES:Obsessive-compulsive disorder is one of the most common neuropsychiatric disorders with a higher lifetime prevalence than schizophrenia, often showing inadequate response to pharmacological and psychotherapeutic treatments. This study aimed to examine the efficacy of adjunctive deep transcranial magnetic stimulation (dTMS) in a randomized, sham-controlled set-up, addressing inadequate response to standard treatments. METHODS:Forty-nine obsessive-compulsive disorder patients were randomly allocated to receive either high-frequency dTMS (20 Hz) or sham stimulation and received 10 sessions of treatment using the H7 coil to target the dorsal anterior cingulate cortex and the medial prefrontal cortex over a period of 2 weeks. Change in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores was the primary outcome measure. Secondary efficacy measures were changes in Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores and response rates as measured by Y-BOCS. RESULTS:The active dTMS group demonstrated a significant reduction in Y-BOCS scores compared with sham (-10.4 vs -2.6 points; P < 0.001), with an effect size of 1.39. Full response rates were 75% in the active group versus 5% in the sham group ( P < 0.001). Anxiety and depressive symptoms also improved significantly in the active group (Hamilton Anxiety Rating Scale: -9.1 vs -2.4 points, P < 0.001; Hamilton Depression Rating Scale: -5.9 vs -1.8 points, P < 0.001). CONCLUSION:Our study demonstrated that dTMS targeting the dorsal anterior cingulate cortex and medial prefrontal cortex significantly improved obsessive-compulsive, anxiety, and depressive symptoms, with faster response rates and fewer sessions compared with previous trials, suggesting that dTMS may serve as an effective early intervention for a wider range of obsessive-compulsive disorder patients.
Adjustment disorder is typically considered a mild mental health condition; however, if left untreated, it can progress to more severe psychiatric disorders. The International Adjustment Disorder Questionnaire (IADQ) was developed to assess adjustment disorders and has been validated in various cultural contexts. Nevertheless, no prior studies have examined the measurement invariance of the IADQ across gender, especially given that men and women respond differently to stressful situations. Additionally, the psychometric properties of the IADQ have not been examined in Indian samples. Therefore, the present study evaluated the psychometric properties and measurement invariance of the IADQ across gender in a sample of 1,069 emerging adults, aged 18–29 years (Mage = 21.59, SDage = 2.65; 56.5% female). Confirmatory factor analysis supported the two-factor structure of the IADQ, comprising preoccupation and failure to adapt. Measurement invariance analysis demonstrated full configural, metric, scalar, and strict invariance across gender. The IADQ demonstrated good internal consistency (α = .817–888, ω = .819 − .889). Furthermore, the IADQ showed significant positive associations with co-occurring psychopathology and negative correlations with positive mental health indicators. Overall, these findings support the reliability and validity of the IADQ and its suitability for gender comparisons among emerging adults.
Low-field magnetic stimulation (LFMS) has shown promising results for treating depression in preclinical and clinical studies. No previous meta-analysis has investigated its effects on depression. The aim of this systematic review and meta-analysis is to identify, evaluate, and summarize the current evidence for the efficacy and tolerability of LFMS in patients with depressive disorder. PubMed, Embase, Scopus, and Google Scholar databases were systematically searched to identify eligible studies published until February 15, 2025. Review protocol was prospectively registered with PROSPERO (CRD420250650519). Meta-analyses using a random-effects model was conducted to calculate pooled estimates. Standardized mean difference (SMD) and odds ratio (OR) were calculated for continuous and categorical outcomes, respectively. Nine randomized controlled trials (RCTs) comprising 571 patients were analysed. Five RCTs (55.5%) had 'some concerns', and 2 (22.2%) had a 'high risk' of bias. A moderate treatment effect size (SMD=-0.61; 95% CI: –0.91 to –0.30; P <0.001) favouring LFMS for the treatment of depression compared with sham stimulation was obtained. LFMS was well-tolerated with no significant difference in the frequency of adverse events reported between LFMS and sham groups, except for a significantly higher risk of myalgia associated with LFMS (OR=2.69; 95% CI: 1.14-6.31, P =0.02). Certainty of evidence on GRADE was 'low' for the primary outcome. LFMS may be a safe and effective neuromodulation technique for adjunctive treatment of depression. There is a need to conduct more robust RCTs with larger sample sizes, longer follow-up durations, and standardized LFMS stimulation parameters to better characterize its safety and efficacy.
