Minor physical anomalies (MPAs) and gamma oscillatory activity have been proposed as associated endophenotypes in schizophrenia. Combining these endophenotypes to create a composite endophenotype may help identify those at risk for schizophrenia better. The present study aims to investigate MPAs and gamma oscillatory activity in schizophrenia patients, their unaffected first degree relatives and healthy controls and appreciate whether they can be used together as a composite endophenotype.This was a cross sectional family study conducted at a tertiary care mental health setup. Ninety participants including schizophrenia patients, their first degree relatives and controls (thirty each) were assessed for MPAs on the Extended Waldrop Scale. All participants underwent an awake, resting 192-channel EEG recording. Spectral power and coherence in 30-100Hz gamma bands were estimated using Welch's averaged periodogram method. One-way ANOVA, chi square test were used for comparing socio-demographic-clinical variables. MANOVA supplemented by one-way ANOVAs (post hoc Tukey HSD) were done for comparison of spectral measures. Pearson's correlation, step-by-step linear discriminant functional and intra-familial correlation analysis were subsequently performed.An endophenotype pattern of finding was found for MPAs in the craniofacial region, the total number of MPAs, spectral power in right temporal region on all bands and in the right parietal region in 50-70Hz and 70-100Hz gamma bands. The three groups were most accurately classified when MPA total score, right temporal 30-50Hz gamma power and right occipital 'intra hemispheric' 50-70Hz gamma coherence were considered together than when considered independently. Significant intra familial correlation was seen for MPA total score and right temporal gamma 30-50Hz power.Composite evaluation of two developmentally linked markers i.e. MPAs and gamma spectral measures may prove useful in categorizing schizophrenia and identifying at-risk individuals.
Background: Internet use has spread across the world due to easy accessibility and affordability. However, it has been creating many problems at several levels. So, there is a need to identify the suitability of psychometric properties and the factor structure of the widely used Internet Addiction Test (IAT) in the Indian settings. Our objective was to perform an exploratory factor analysis on the IAT and to test the reliability of the scale. Methods: It was a cross-sectional study that included various professional groups. We used an online questionnaire that included sociodemographic details and Young’s IAT. Exploratory factor analysis was used to identify the factor structure of Young’s IAT in the Indian setup. Results: The mean age of the sample (N = 1,782) was 27.7 years (SD = 8.74) with a predominantly male population 1040 (58.4%). In total, 1.0% (17) of the sample had significant problems with internet usage, whereas 13% (232) were in the range of frequent/occasional problems, and the mean score on IAT was 32 (SD = 16.42). Exploratory factor analysis revealed two factors that explained 49% of the variance (Kaiser–Meyer–Olkin measure of sampling adequacy: 0.95, Bartlett’s test of sphericity: P = 0.000). They were “mood and relationship issues” and “duration and productivity.” Cronbach’s α was 0.92, which indicates a high level of internal consistency. Conclusion: In Indian settings, IAT can be understood based on the two-factor structure. The scale has excellent reliability. Further studies are needed to replicate these results, by using confirmatory factor analysis and validity testing.
Cannabinoids can induce clinically significant psychotic episodes immediately following exposure, that can persist well beyond the duration of intoxication, and that require clinical intervention: cannabinoid induced acute and persistent psychosis (CIAPP). CIAPP may represent a distinct subtype of psychotic disorder that in our current nomenclature is subsumed under schizophrenia. The importance of parsing out different subtypes of chronic recurrent psychoses that are currently lumped under schizophrenia, is to more accurately diagnose and estimate prognosis, tailor disorder-specific treatments, and to minimize iatrogenic harm. Furthermore, characterizing the specific biological correlates of subtypes at the genetic and cellular levels, will be critical in validating the subtypes. However, the sporadic occurrence of CIAPP makes it is harder to study. Every year, there is a predictable spate of hospitalizations for CIAPP that occur at the Central Institute of Psychiatry, Ranchi, India following certain Indian festivals during which there is the ritual use of cannabis. Since the date of these festivals is predetermined, the capture and study of CIAPP cases can occur in a planned manner. In addition to festival-related cases, there are also CIAPP cases hospitalized throughout the year. In this prospective study, hospitalized cases of CIAPP were compared to individuals who 1) were hospitalized for psychosis unrelated to cannabis, 2) hospitalized for cannabis use disorder, and 3) were healthy. Demographic information, personal and family history of mental illness and drug use, psychosis (PANSS), and cognition (Cogstate battery) and psychophysiological indices of information processing (Auditory Steady State Response and noise [LZC]) were assessed 1) at admission, 2) mid-hospitalization, 3) around discharge, and 4) within 6 months post-discharge. In this prospective study, 50 consecutive hospitalized cases of CIAPP with toxicological confirmation of cannabis exposure have been studied and compared to 3 control groups. Preliminary results suggest that cases of CIAPP have a distinct phenomenological presentation including equivalent scores of psychosis, marked affective symptoms, lower schizotypy, and better performance on some cognitive tasks. Furthermore, CIAPP have reduced connectivity but preserve gamma band power. At the time of discharge, and 4–6 months later, CIAPP cases have fewer residual symptoms. Two cases have relapsed after resuming the consumption of cannabis, supporting a role for cannabis in the expression of psychosis. If these results are confirmed in a larger sample, it would suggest that CIAPP may represent a distinct subtype of psychotic disorder that has characteristic behavioral, cognitive and psychophysiological features. Longer longitudinal studies are warranted to understand the course and prognosis of CIAPP.
Abstract Introduction Self disorders in schizophrenia have been suggested to have distinct neurobiological underpinnings. Using comprehensive neuro‐scientific assessments including a neurophysiological, a neurochemical and a neuropsychological marker, this study assesses disordered‐“self” in schizophrenia. Methods Twenty schizophrenia patients with first rank symptoms (FRS;FRS+), 20 patients without FRS (FRS−) and 20 healthy controls (HC) were assessed for psychopathology, especially on specially designed FRS score sheets with a narrow and a broad definition. Resting state electroencephalography was acquired using 256‐electrodes; gamma spectral‐power was measured in 8 regions of interest. Serum BDNF and self‐monitoring were also assessed. Comparative and correlation analysis were conducted in addition to a step‐wise discriminant function analysis. Results FRS+ group with greater positive symptom score and a lower negative symptom score, showed significantly increased gamma spectral power, especially on right hemispheric regions, along with lower BDNF levels and lower scores on self‐monitoring compared to FRS− and HC. Serum BDNF levels and gamma spectral power in the region corresponding right inferior parietal lobule were identified as predictors that most accurately classified the defined groups. Conclusions Schizophrenia patients satisfying the criteria of presence of first rank symptoms represent a distinct neurodevelopmental subgroup with associated features of predominantly positive symptoms, significantly lower neurotrophin levels, aberrant resting state brain activity in the heteromodal association cortex and performing poorer on self‐monitoring tasks.
Abstract Background: Persistent somatoform pain disorder (PSPD) is a chronic bodily pain condition associated with psychological and emotional distress. It is highly comorbid with other psychiatric disorders and up to 50% or more of the general population report one or more somatic symptoms in their lifetime. Transcranial magnetic stimulation (TMS) has been proven as a safe and effective cortical stimulation technique to alleviate the symptoms in chronic pain conditions. Aim: With this narrative review, we planned to evaluate all the existing studies to know the efficacy and tolerability of TMS in patients with PSPD. Materials and Methods: The review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO). On the basis of predefined selection criteria, 13 studies were found to be related to TMS in somatoform pain. Upon further screening, a total of 7 potentially relevant studies ( n = 445) were included in this review. Results: The result outcomes reflect a reduction in pain perception and pain intensity in the TMS group. There was also subjective improvement in associated symptoms such as low mood, anxiety, and dysfunction. However, there were considerable variations in study parameters such as hypothesis, stimulation protocol, and study methodology, which may have impacted the final review outcomes. Conclusion: TMS is an effective and safe treatment for PSPD, but the evidence is still anecdotal and theta burst stimulation can be a potential better option than conventional TMS. There is a need for larger, longer, and possibly multicentric replication of trials with TMS and PSPD.
A significant body of evidence on the role of TMS in neurology and psychiatry has emerged from Indian studies.We aimed to assess the existing and emerging trends of research on TMS as a diagnostic or therapeutic tool in India using bibliometric analysis.A total of 146 publications, retrieved from various databases, were analyzed using Microsoft Excel and VOSviewer. We found a linear positive growth of publications in India in the field of TMS and neuropsychiatry, with about 3000 citations so far. The most researched diagnosis was schizophrenia. NIMHANS, Bengaluru, had the highest number of publications. The journal with the highest number of publications was the Asian Journal of Psychiatry, and that with the highest citations was the Journal of Affective disorders.The growth of Indian research in the field of TMS corresponds to that of the global one but also suggests the need for more studies to match the research output from other countries.
Background: Cognitive behavioral therapy for insomnia (CBT-I) is considered the gold standard for insomnia, but its relative role in improving cognition has not been addressed. Hence, we aimed to study the effect of CBT-I on sleep quality, psychopathology, and neuropsychological performance in schizophrenia. Methods: Randomly allocated 40 right-handed schizophrenia patients with insomnia were delivered four sessions of weekly CBT-I. Pre-postassessments with Pittsburgh Sleep Quality Index (PSQI), AIIMS Comprehensive Neuropsychological Battery (AIIMS NCB), Positive and Negative Syndrome Scale, Multidimensional Fatigue Inventory, Warwick-Edinburg Mental Well-being Scale (WEMWBS), and Global Assessment Functioning (GAF) were done. Results: CBT-I had significant effects on PSQI, AIIMS NCB total and memory scores, WEMWBS, and GAF compared to the control group. Conclusion: In a subset of schizophrenia patients with insomnia, sleep-based interventions improve sleep quality and neuropsychological performance.
Introduction: Irony comprehension (IC) has been described as a schizophrenia (SCZ) disease marker. High variability exists in the measurement of IC. We aimed to assess content and “known-groups” validity of an Indian, comic-based, computerized-IC task. Methods A 15-story IC task was prepared. Content validity of the IC task stimuli was assessed by experts in mental health. Performance on the IC task was compared between 15 SCZ patients and 15 healthy controls (HC). Known-groups validity was assessed using discriminant function analysis. Results Content validity of the IC task was optimum. Lower number of correct responses and longer reaction times for irony stimuli were seen in SCZ patients, compared to HC. Both these measures showed 100% accuracy in discriminating SCZ from HC, therefore, implying excellent “known-groups” validity. Conclusion The newly designed IC task has good psychometric properties, in terms of content and “known-groups” validity.
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