Year : 2017  |  Volume : 59  |  Issue : 6  |  Page : 148--149

Bombay Psychiatric Society Silver Jubilee Award


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. Bombay Psychiatric Society Silver Jubilee Award.Indian J Psychiatry 2017;59:148-149

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. Bombay Psychiatric Society Silver Jubilee Award. Indian J Psychiatry [serial online] 2017 [cited 2021 Oct 27 ];59:148-149
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Efficacy of adjunctive single session counselling for medically unexplained physical symptoms: A randomized controlled trial

Vikas Menon*, Balasubramanian Shanmuganathan, Siddharth Sarkar

*Dept. of Psychiatry and National Drug Dependence and Treatment Centre, All India Institute of Medical Sciences (AIIMS), New Delhi (*denotes presenting author). [email protected]

Background: Medically unexplained physical symptoms (MUPS) are often poorly responsive to standard treatments.

Aims: To assess short term efficacy of adjunctive single session counselling for patients with MUPS.

Setting and design: Randomized controlled trial at a psychosomatic clinic of a tertiary care hospital.

Methods and Material: Patients with MUPS were randomized to receive either the single session counselling (intervention group) (n=41) or control group which received treatment as usual (n=35). The counselling intervention focussed on three areas - cognitive reattribution, shifting focus and guided muscular relaxation; and lasted around 30 minutes. The two groups were assessed at baseline and after 1 month for change in outcome measures.

Statistical analysis used: Repeated measures analysis of variance (RMANOVA)

Results: Both groups did not differ on change in the primary outcome measure: Patient Health Questionnaire - 15 scores (p=0.055). However, at follow up, the intervention group showed statistically greater reduction in number of workdays lost (p=0.005). Trend level changes were noted for depressive symptom reduction only in the intervention group (p = 0.022).

Conclusions: One session CBT-based therapy demonstrates potentially important benefits over standard care among Indian patients with MUPS. Further testing in larger samples with longer follow up periods is therefore recommended.

Keywords: medically unexplained symptoms; cognitive-behaviour therapy; randomized controlled trial; somatoform disorders; somatization; somatic symptoms

Role of vitamin D supplementation in patients with depressive disorders and hypovitaminosis D: A longitudinal study

Naresh Nebhinani*, Praveen Sharma, Navratan Suthar

*Department of Psychiatry, 2 Department of Biochemistry, All India Institute of Medical Science, Jodhpur, Rajasthan, 342005 [email protected]

Background and aim: Available literature is inconsistent for the role of vitamin D supplementation in depression. With scarcity of Indian data, we aimed to study vitamin D deficiency in patients with depression, its association with time to remission and role of vitamin D supplementation.

Methods: One hundred fifty-eight outpatients with depressive disorders were consecutively assessed for vitamin D deficiency, severity of depression, physical activity and nutritional habits and followed-up for one year. Eighty-seven patients completed follow-up for one year (55% retention).

Results: Mean serum vitamin D level was 11.9 ng/ml and majority of patients (85%) had vitamin D deficiency (<20 ng/mL). Significant predictors of hypovitaminosis D were being female, unemployed or homemaker, from nuclear family and with smaller height. Vitamin D deficient patients took significantly longer time in remission than non-deficient patients (2.86 months vs. 1.35 months, p=0.006). Patients with vitamin D deficiency received vitamin D supplementation and subsequently their time to remission was comparable to non-deficient group.

Conclusions: Majority of patients had vitamin D deficiency, took longer time to remission and reported improvement with vitamin D supplementation. It signifies the importance of treating hypovitaminosis D for effective management of depression, to avoid delay in response, and incomplete remission.

Keywords: Vitamin D, hypovitaminosis D, time to remission, depression, India

The efficacy of adjunctives rTMS over the right dorsolateral prefrontal cortex on executive, cognitive functions and psychopathology in early onset schizophrenia

Dr. V.Gaikwad 1 , Prof (Dr.) Vinod Kr Sinha 2

1 PGRMO, BARC Hospital, Mumbai 400094; 2 Director Professor, Central Institute of Psychiatry (CIP), Ranchi 834006. [email protected]

Background: Early noninvasive electrical stimulation studies suggested that accentuation of non-dominant dorsolateral prefrontal (DLPFC) cortex activity might prove valuable in symptomatic treatment of refractory neuropsychiatric diseases and improvement of executive functioning via modulation of emotion and affect. This study aimed to test this hypothesis in early onset schizophrenia patients using high frequency noninvasive repetitive trans-cranial magnetic (rTMS) stimulation.

Materials & Methods: A 2-arm double-blind randomized controlled trial was conducted with 40 patients (20 active & 20 sham group) having early onset schizophrenia who underwent ten sessions (biweekly) of high frequency rTMS stimulation to the right DLPFC. Assessments included Calgary Depression Scale for Schizophrenia (CDSS), Positive and Negative Symptom Scale (PANSS), Mini Mental State Examination (MMSE), N-Back and Trail making Test A and B (TMT A &B), Wisconsin Card Sorting Test (WCST) at Baseline, after 1 st session of rTMS, later at 2 nd week (completion of 10 sessions) and 4 th week after the last session of rTMS.

Results: Overall, there was significant reduction in severity of positive symptoms, general psychopathology and total score (PANSS-PS {p=.000}, GP {p=.020}, T {p=.000}); depressive symptoms (CDSS {p=.012}); improvement in cognitive (MMSE {p=.000}) and executive functioning (N-Back {p=.001}; TMT A {p=.001} and B {p=.007} and WCST {p=.019}) in the active patient's v/s sham group.

Conclusion: Excitatory stimulation of right sided DLPFC using rTMS could induce cortical neural modulation to bring functional and neuro-chemical changes in frontal lobe to improve negative symptoms, mood, and executive functioning in patients suffering from early onset schizophrenia.

Key words: Early onset Schizophrenia, Executive functions, DLPFC, rTMS, WCST.