Bhavesh Lakdawala - Academia.edu (original) (raw)
Papers by Bhavesh Lakdawala
Journal of Affective Disorders, 2022
Psychiatry Research, 2021
AIM To explore the prevalence of residual symptoms (both depressive and manic) and their correlat... more AIM To explore the prevalence of residual symptoms (both depressive and manic) and their correlates in subjects with bipolar disorder in clinical remission. METHODOLOGY This multicentric cross-sectional study included patients in clinical remission recruited across the 14 centers. The patients were evaluated on the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) for the prevalence of residual symptoms. A score of ≤7 on both scales defined the presence of residual symptoms. RESULTS Four-fifth (79.8%) of the participants had residual symptoms, with 130 (16.8%) having only residual depressive symptoms, 74 (9.6%) having only residual manic symptoms, and 413 (53.4%) having both depressive and manic residual symptoms, on HDRS and YMRS. The residual symptoms were related to the polarity of the most recent episode and the lifetime predominant polarity. Higher numbers of lifetime depressive episodes are associated with higher residual depressive symptoms, and higher numbers of lifetime manic episodes are associated with higher chances of having residual manic symptoms. CONCLUSIONS A large proportion of patients with bipolar disorder have residual symptoms during the remission phase. Clinicians need to make efforts to identify and address the same to improve the treatment outcome.
Journal of Affective Disorders, 2021
Asian Journal of Psychiatry, 2021
AIM To evaluate the prescription pattern of patients with BD, currently in clinical remission. Ad... more AIM To evaluate the prescription pattern of patients with BD, currently in clinical remission. Additional aim of the study was tocompare the prescription pattern across different study centres. METHODOLOGY Prescription of 773 patients, currently in clinical remission, recruited from the outpatient setting of 14 General Hospital Tertiary Care Units of tertiary care centres in the country were evaluated. RESULTS Almost all (98.1 %) participants were on medications at the time of assessment. In terms of conventional mood stabilizers, those receiving valproate (44.2 %), out-numbered those receiving lithium (38.9 %). A small proportion (7.4 %) was receiving a combination of both valproate and lithium. About two-third (62.5 %) were receiving at least one antipsychotic medication, with olanzapine (31.7 %) being the most commonly prescribed antipsychotic, followed by quetiapine (11.1 %), and risperidone (9.6 %). About one-third (34.4 %) of the participants were receiving antidepressants, with sertraline (22.6 %) forming bulk of the prescription. Less than half (43.9 %) of the participants were also receiving a benzodiazepine medication at the time of assessment, with chlordiazepoxide (18 %) being the most common agent, followed by clonazepam (14.5 %). There was variation in the prescription patterns across different centres, in terms of monotherapy, polypharmacy, use of preferred conventional mood stabilizers, use of various antipsychotics and antidepressants. CONCLUSION Besides conventional mood stabilizers, about two-third of patients with bipolar disorder received concomitant antipsychotics, one-third received concomitant antidepressants and less than half received benzodiazepines.
Nordic Journal of Psychiatry, 2021
AIM This study aimed to evaluate the prevalence of unipolar mania (UM) in a group of patients of ... more AIM This study aimed to evaluate the prevalence of unipolar mania (UM) in a group of patients of bipolar disorder (BD). Additionally, effort was made to evaluate the demographic, clinical and treatment related factors, which distinguish subjects of UM from BD. METHODOLOGY Seven hundred and seventy-three patients with BD, of at least 10 years duration, recruited from 14 General Hospital Units of tertiary care centers from India were evaluated for UM. RESULTS The prevalence of UM, varied from 5.4% to 20.3%, depending on the definition used. With the most stringent definition of ≥4 episodes of mania and at least 5 years of follow-up, the prevalence of UM was 5.4%. Compared to patients of BD, who have episodes other than mania too, those with UM had lower proportion of patients with lifetime history of suicide attempts, spent less time in the episodes in their lifetime and had lower severity of residual depressive and manic symptoms. Further, compared to those with episodes other than mania too, those with UM had higher number of manic episodes per year of illness, had higher proportion of patients who had more than five episodes in the lifetime and had higher proportion of those with at least one episode with psychotic symptoms in the lifetime. CONCLUSION The present study suggests that a small proportion of patients with BD have UM course and this runs a different clinical course compared to that seen in patients with traditionally recognized as BD.
Comprehensive Psychiatry, 2021
RAFT Polymerization, 2021
Journal of Affective Disorders, 2021
OBJECTIVES This multicentric study from India aimed to evaluate the long term course and outcome ... more OBJECTIVES This multicentric study from India aimed to evaluate the long term course and outcome of bipolar disorder (BD). METHOD Seven hundred and seventy-three participants diagnosed with BD, attending 14 outpatient clinic centers across the country, were evaluated using the National Institute of Mental Health- Retrospective Life Charts to assess the long term course of BD. RESULTS The mean age of onset of the first episode of illness of the study sample was 26.3 (8.54) years, and mean duration of illness at the time of assessment was 233.05 (94.55) months. In terms of the total number of lifetime episodes, the mean number of manic episodes (mean: 3.68; SD: 4.75) exceeded the mean number of depressive episodes (mean: 3.36; SD: 5.51). The mean numbers of total lifetime episodes were 8.58 (10.6%). When the number of episodes per year was computed, the mean number of manic episodes per year exceeded that of the mean number of depressive episodes. Compared to females, a higher proportion of males had a history of comorbid substance dependence. LIMITATIONS The course was assessed retrospectively and the study was limited to participants attending the outpatient clinics. CONCLUSIONS The course of BD in India differs from that described from developed countries in the form of a number of manic episodes exceeding the depressive episodes.
Indian Journal of Mental Health(IJMH), 2016
Journal of Geriatric Mental Health, 2019
Aim of the Study: This study aimed to evaluate the prevalence and risk factors for suicidal ideat... more Aim of the Study: This study aimed to evaluate the prevalence and risk factors for suicidal ideations (SIs) and suicidal attempts (SAs) among elderly patients with depression, seeking treatment in psychiatric setups. Methodology: The study sample comprised 488 elderly patients (age ≥60 years) with depression recruited across eight centers. These patients were evaluated on the Columbia Suicide Severity Rating Scale, Geriatric Depression Scale-30, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-15 Scale, UCLA Loneliness Scale, Revised Social Connectedness Scale, and Montreal Cognitive Assessment Scale. Results: “Wish to die” was present in one-fifth (21.7%) and about one-fourth (26.6%) of the study samples at the time of assessment and in the lifetime, respectively. Overall, one-fourth (25.8%; n = 126) of the participants had SIs at the time of assessment and two-fifths (41.5%; n = 203) had SIs in the lifetime. Overall, about one-tenth (9.2%) of the participants made an SA just before assessment and one-sixth (16.6%) had at least one SA in the lifetime. Compared to those with no SIs in the lifetime, those with current and lifetime SIs had lower age of onset and longer duration of illness, less often had a comorbid physical illness, more often had recurrent depressive disorder, had significantly higher anxiety as assessed on GAD-7 scale, and had significantly higher prevalence of loneliness and significantly higher prevalence of cognitive deficits. When those with any current and lifetime SAs and those with no lifetime SAs were compared, those with SAs had longer duration of current treatment and more often had comorbid physical illness and significantly higher cognitive deficits. Conclusions: The present study suggests that about one-fourth (25.8%) of the elderly with depression have SIs at the time of assessment and about two-fifths (41.5%) have lifetime SIs. About one-sixth of the elderly patients with depression make at least one SA in the lifetime and about one-tenth attempt suicide in recent past. In terms of risk factors for SIs and SAs, the present study suggests that the presence of comorbid anxiety, loneliness, and cognitive deficits possibly predispose the elderly to suicidal behaviors.
Journal of Geriatric Mental Health, 2018
Aim of the Study: This study aims to evaluate the prevalence of physical comorbidities and prescr... more Aim of the Study: This study aims to evaluate the prevalence of physical comorbidities and prescription patterns in elderly patients with depression. Materials and Methods: This study included 488 elderly patients (aged ≥60 years) with depression recruited across eight centers. A self-designed physical comorbidity checklist was used to assess for the presence of various physical comorbidities and prescription of psychotropic medications was recorded. Results: More than three-fourth of the study sample (n = 384; 78.7%) had at least one physical comorbidities and one-third (36.7%) of the samples had at least three physical illnesses. About half of the study samples had hypertension (47.3%) and slightly more than one-fourth had diabetes mellitus (29%). The most common physical illness involved the cardiovascular system (51.5%), followed by endocrinological system (39.3%), orthopedic and joint-related diseases (35%), and ophthalmological problems (22.3%). Those with physical comorbidity had higher severity of depression, anxiety, and somatic symptom. Sertraline was the most preferred antidepressant followed by escitalopram and mirtazapine. Only 12.7% of the sample was prescribed antipsychotics of which quetiapine and olanzapine were the most commonly used agents. Benzodiazepines were prescribed to more than half of the study samples (56.55%), with clonazepam being the most preferred benzodiazepine followed by lorazepam. Compared to those without hypertension, those with hypertension were more commonly prescribed sertraline and escitalopram and less commonly prescribed fluoxetine. Similarly, compared to those without diabetes mellitus, those with diabetes mellitus were more commonly prescribed sertraline and less commonly prescribed fluoxetine. Conclusion: Comorbid physical illnesses are highly prevalent in elderly participants with depression with hypertension being the most common physical comorbidity followed by diabetes mellitus and osteoarthritis. The presence of physical comorbidity is associated with more frequent prescription of sertraline and escitalopram.
Journal of Geriatric Mental Health, 2018
Aim of the Study: To assess the symptom profile of depression among elderly patients presenting t... more Aim of the Study: To assess the symptom profile of depression among elderly patients presenting to psychiatric outpatient settings. An additional aim was to evaluate the influence of gender, age of onset, age at presentation, and type of episode (i.e., the first episode versus recurrent depressive episodes) on symptom profile of geriatric depression. Materials and Methods: This multicentric study was conducted at eight centers in which 488 elderly patients (aged ≥60 years) with depression were evaluated on Geriatric Depression Scale (GDS-30), Generalized Anxiety Disorder-7 Scale (GAD-7), Patient Health Questionnaire-15 (PHQ-15) scale, and Columbia Suicide Severity Rating Scale. Results: Males had significantly higher prevalence of comorbid substance dependence, whereas females had significantly higher prevalence of comorbid psychiatric disorders. As per the GDS-30, about two-third or more of the study sample had symptoms of feeling helpless (71.7%), often getting restless and fidgety (70.1%), dropped many of their activities (68.4%), frequently feel like crying (67.4%), trouble concentrating (67%), feels pretty worthless (66.4%), often feeling downhearted and blue (65.8%), frequently getting upset over little things (64.8%), and not satisfied with life (62.9%). More than two-third of the sample had all the symptoms of anxiety as per the GAD-7 and 7 out of the 14 somatic symptoms as per the PHQ-15. When comparisons were made between males and females, significant difference in prevalence was noted for some of the depressive symptoms as assessed by the GDS-30 and somatic symptoms as assessed by the PHQ-15, but no differences emerged in terms of anxiety symptoms. Significantly higher proportion of females reported active suicidal ideation with specific plan and intent and had higher intensity of suicidal ideations. Differences in symptom profile were also noted with regard to age of onset (<60 and ≥60 years), age at presentation (<70 and ≥70 years), and type of depression (single versus multiple episodes). Conclusion: The present study suggests that somatic and anxiety symptoms are highly prevalent among elderly patients with depression. Further, it is evident that there are certain differences in the symptom profile of depression among male and female patients with depression. The present study also reveals that age of onset, age at presentation, and number of episodes could also influence the symptom profile of depression among the elderly.
European Polymer Journal, 2019
Abstract We describe the sequential incorporation of the quaternized monomer N-(2-(Methacryloylox... more Abstract We describe the sequential incorporation of the quaternized monomer N-(2-(Methacryloyloxy)ethyl)-N,N-dimethylheptan-1-ammonium (QDM) (from 1 up to 5 mol %) into 2-((dimethylamino)ethyl methacrylate) polymer chains (PDMAEMA), via reversible addition-fragmentation chain transfer (RAFT) technique, to yield quasi-block copolymers (PDMAEMA-qb-P(DMAEMA-co-QDM)) with modified hydrophilic nature and thermo-induced self-assembly properties in aqueous solutions. This chemical modification promotes the formation of metastable nanostructures in aqueous medium. The morphological transitions were investigated by means of atomic force microscopy (AFM), dynamic light scattering (DLS), rheology and turbidimetry. The results indicated that the obtained nanostructures were stabilized by associative and cationic interactions conveyed by the quaternized moieties within the polymer chains. The size of these nanostructures could be modified as a function of molar mass, copolymer composition and temperature. The method described denotes an interesting alternative to modify the thermo-induced self-assembly behavior of PDMAEMA based copolymers employing low amounts of quaternized moieties.
Indian Journal of Mental Health(IJMH), 2016
Background: Mental illness is a major contributor to global disease burden and this is expected t... more Background: Mental illness is a major contributor to global disease burden and this is expected to increase over years. In community mental illness has not been well understood by the lay persons, resulting in stigmatizing attitudes towards persons with mental illness and mentally ill. High mental health literacy which includes adequate knowledge and positive attitudes in college students towards psychiatric illnesses would benefit society at large. Aims: Aim of the study was to assess knowledge and attitude of college students of Medical, Arts Faculties towards the mentally ill and socio-demographic correlates using CAMI subscales. Methodology: Medical college and Arts colleges were surveyed Cross Sectionally regarding students' attitude towards psychiatric illness using the Community Attitude towards the Mentally Ill (CAMI) scale. Totally 1231 Students' responses were analyzed using appropriate statistical methods on SPSS version 15.0. Results: On CAMI scale, students had positive attitudes for Benevolence subscale & Community Mental Health Ideology Subscale. There was a mixed response on Social Restrictiveness subscale and negative attitude was found on Authoritarianism subscale in majority items. Significant differences were observed in attitude towards mentally ill by gender, faculty of education, family type and domicile. Conclusions: These results suggest that widespread educational campaigns need to be implemented across the college students to increase knowledge about mental illness and reduce stigma towards mental illness and mentally ill persons by educational interventions and training which will benefit community at large.
Journal of Geriatric Mental Health, 2018
Aim of the Study: This study aimed to evaluate the prevalence of loneliness and its relationship ... more Aim of the Study: This study aimed to evaluate the prevalence of loneliness and its relationship with social connectedness and depression in elderly. Additional aims were to evaluate the demographic and clinical factors associated with loneliness and social connectedness in elderly patients with depression. Methodology: The study sample comprised 488 elderly patients (age ≥60 years) with depression recruited across 8 centers. These patients were evaluated on Geriatric Depression Scale (GDS-30), Generalized Anxiety Disorder-7 Scale (GAD-7), Patient Health Questionnaire-15 (PHQ-15) Scale, Columbia Suicide Severity Rating Scale, UCLA Loneliness Scale (LS), and Revised Social Connectedness Scale. Results: About three-fourth (77.3%) of the entire sample reported the presence of loneliness. With respect to specific loneliness symptom, 62.5% reported lack of companionship, 58.7% reported being left out in life, and 56.5% of the individuals reported felt isolated from others. No gender differences were noted in the prevalence of any loneliness symptom. Higher loneliness scores had significant positive correlation with severity of depression, anxiety, and somatic symptoms as assessed by GDS-30, PHQ-15, and GAD-7, respectively, in individuals of both the genders. Higher social connectedness was associated with higher level of anxiety and lower loneliness in females only. Being currently single, older age, longer duration of illness, presence of family history of mental illness, presence of comorbid physical illness, and absence of substance abuse were associated with higher loneliness. With regard to suicidality, higher loneliness was associated with nonspecific active suicidal thoughts, active suicidal ideations with and without intent, nonsuicidal behavior, and higher intensity of suicidal ideations. Conclusions: About three-fourth of the elderly patients with depression also have associated loneliness. Loneliness is associated with higher severity of depression, anxiety, and somatic symptoms. Severity of depression is associated with loneliness but not with social connectedness. Lower social connectedness among elderly females with depression is associated with higher loneliness, but this is not true for elderly males with depression.
Psychiatry Research, 2017
The International journal of social psychiatry, 2017
Stigma is very common among caregivers of patients with severe mental disorder; however, there is... more Stigma is very common among caregivers of patients with severe mental disorder; however, there is lack of national level data from India. To assess affiliate stigma and its correlates among caregivers of patients with severe mental disorders. For this, caregivers of patients with schizophrenia ( N = 707), bipolar disorder ( N = 344) and recurrent depressive disorder ( N = 352) were assessed on Stigma scale for Caregivers of People with Mental Illness and General Health Questionnaire. Caregivers of patients with schizophrenia reported significantly higher stigma than patients with bipolar disorder and recurrent depressive disorder. Caregiver of patients with bipolar disorder reported significantly greater stigma than the caregivers of patients with recurrent depressive disorder. Higher caregiver stigma in all the diagnostic groups was associated with higher psychological morbidity in caregivers. Higher stigma in caregivers of schizophrenia was seen when the patient had younger age of...
The International journal of social psychiatry, Jan 3, 2015
To assess the phenomenology and associated beliefs in patients with Dhat syndrome. A total of 780... more To assess the phenomenology and associated beliefs in patients with Dhat syndrome. A total of 780 male patients aged more than 16 years were recruited from 15 centers spread across the country and were assessed on Dhat Syndrome Questionnaire. The most commonly reported reasons for passage of Dhat were excessive masturbation (55.1%), sexual dreams (47.3%), excessive sexual desire (42.8%) and consumption of high energy foods (36.7%). The most common situation in which participants experienced passage of Dhat were as 'night falls' (60.1%) and 'while passing stools' (59.5%). The most common consequence due to passage of Dhat was weakness in sexual ability (75.6%). In terms of psychological and somatic symptoms, the common symptoms included bodily weakness (78.2%); feeling tired or having low energy (75.9%); feeling down, depressed, or hopeless (67.9%); and little interest or pleasure in doing things (63.7%). In terms of treatment expectations, about half of the patients ...
The Journal of Sexual Medicine, 2015
There are limited numbers of studies on Dhat syndrome. Major limitations of the existing literatu... more There are limited numbers of studies on Dhat syndrome. Major limitations of the existing literature are heterogeneous assessment methods used to describe the comorbidity and small sample size from isolated centers. To assess comorbidity with a common methodology in patients with Dhat syndrome from multiple centers across India. Using a cross-sectional design, this multicentric study involved assessment of 780 male patients, aged more than 16 years, across 15 study centers. ICD-10 criteria (for evaluation of psychiatric morbidity and sexual dysfunction) RESULTS: About one-third (32.8%) of the cases had no comorbidity. One-fifth (20.5%) of the patients had comorbid depressive disorders and another one-fifth (20.5%) had comorbid neurotic, stress-related and somatoform disorders. Half (51.3%) of the study sample had comorbid sexual dysfunction. When various combinations of comorbidities were evaluated, it was seen that more than one-fourth (28.7%) of the patients had only comorbid sexual dysfunction and one-sixth (15.9%) had only comorbid depressive/anxiety disorders. A little more than one-fifth (22.6%) had comorbidity of both sexual dysfunction and depressive/anxiety disorders. Comorbid sexual dysfunction is seen in half of the cases of Dhat syndrome, and it is more common than comorbid depressive and anxiety disorders. Grover S, Avasthi A, Gupta S, Dan A, Neogi R, Behere PB, Lakdawala B, Tripathi A, Chakraborty K, Sinha V, Bhatia MS, Pattojoshi A, Rao TSS, and Rozatkar A. Comorbidity in patients with Dhat syndrome: A nationwide multicentric study. J Sex Med **;**:**-**.
Indian Journal of Psychiatry, 2015
Journal of Affective Disorders, 2022
Psychiatry Research, 2021
AIM To explore the prevalence of residual symptoms (both depressive and manic) and their correlat... more AIM To explore the prevalence of residual symptoms (both depressive and manic) and their correlates in subjects with bipolar disorder in clinical remission. METHODOLOGY This multicentric cross-sectional study included patients in clinical remission recruited across the 14 centers. The patients were evaluated on the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) for the prevalence of residual symptoms. A score of ≤7 on both scales defined the presence of residual symptoms. RESULTS Four-fifth (79.8%) of the participants had residual symptoms, with 130 (16.8%) having only residual depressive symptoms, 74 (9.6%) having only residual manic symptoms, and 413 (53.4%) having both depressive and manic residual symptoms, on HDRS and YMRS. The residual symptoms were related to the polarity of the most recent episode and the lifetime predominant polarity. Higher numbers of lifetime depressive episodes are associated with higher residual depressive symptoms, and higher numbers of lifetime manic episodes are associated with higher chances of having residual manic symptoms. CONCLUSIONS A large proportion of patients with bipolar disorder have residual symptoms during the remission phase. Clinicians need to make efforts to identify and address the same to improve the treatment outcome.
Journal of Affective Disorders, 2021
Asian Journal of Psychiatry, 2021
AIM To evaluate the prescription pattern of patients with BD, currently in clinical remission. Ad... more AIM To evaluate the prescription pattern of patients with BD, currently in clinical remission. Additional aim of the study was tocompare the prescription pattern across different study centres. METHODOLOGY Prescription of 773 patients, currently in clinical remission, recruited from the outpatient setting of 14 General Hospital Tertiary Care Units of tertiary care centres in the country were evaluated. RESULTS Almost all (98.1 %) participants were on medications at the time of assessment. In terms of conventional mood stabilizers, those receiving valproate (44.2 %), out-numbered those receiving lithium (38.9 %). A small proportion (7.4 %) was receiving a combination of both valproate and lithium. About two-third (62.5 %) were receiving at least one antipsychotic medication, with olanzapine (31.7 %) being the most commonly prescribed antipsychotic, followed by quetiapine (11.1 %), and risperidone (9.6 %). About one-third (34.4 %) of the participants were receiving antidepressants, with sertraline (22.6 %) forming bulk of the prescription. Less than half (43.9 %) of the participants were also receiving a benzodiazepine medication at the time of assessment, with chlordiazepoxide (18 %) being the most common agent, followed by clonazepam (14.5 %). There was variation in the prescription patterns across different centres, in terms of monotherapy, polypharmacy, use of preferred conventional mood stabilizers, use of various antipsychotics and antidepressants. CONCLUSION Besides conventional mood stabilizers, about two-third of patients with bipolar disorder received concomitant antipsychotics, one-third received concomitant antidepressants and less than half received benzodiazepines.
Nordic Journal of Psychiatry, 2021
AIM This study aimed to evaluate the prevalence of unipolar mania (UM) in a group of patients of ... more AIM This study aimed to evaluate the prevalence of unipolar mania (UM) in a group of patients of bipolar disorder (BD). Additionally, effort was made to evaluate the demographic, clinical and treatment related factors, which distinguish subjects of UM from BD. METHODOLOGY Seven hundred and seventy-three patients with BD, of at least 10 years duration, recruited from 14 General Hospital Units of tertiary care centers from India were evaluated for UM. RESULTS The prevalence of UM, varied from 5.4% to 20.3%, depending on the definition used. With the most stringent definition of ≥4 episodes of mania and at least 5 years of follow-up, the prevalence of UM was 5.4%. Compared to patients of BD, who have episodes other than mania too, those with UM had lower proportion of patients with lifetime history of suicide attempts, spent less time in the episodes in their lifetime and had lower severity of residual depressive and manic symptoms. Further, compared to those with episodes other than mania too, those with UM had higher number of manic episodes per year of illness, had higher proportion of patients who had more than five episodes in the lifetime and had higher proportion of those with at least one episode with psychotic symptoms in the lifetime. CONCLUSION The present study suggests that a small proportion of patients with BD have UM course and this runs a different clinical course compared to that seen in patients with traditionally recognized as BD.
Comprehensive Psychiatry, 2021
RAFT Polymerization, 2021
Journal of Affective Disorders, 2021
OBJECTIVES This multicentric study from India aimed to evaluate the long term course and outcome ... more OBJECTIVES This multicentric study from India aimed to evaluate the long term course and outcome of bipolar disorder (BD). METHOD Seven hundred and seventy-three participants diagnosed with BD, attending 14 outpatient clinic centers across the country, were evaluated using the National Institute of Mental Health- Retrospective Life Charts to assess the long term course of BD. RESULTS The mean age of onset of the first episode of illness of the study sample was 26.3 (8.54) years, and mean duration of illness at the time of assessment was 233.05 (94.55) months. In terms of the total number of lifetime episodes, the mean number of manic episodes (mean: 3.68; SD: 4.75) exceeded the mean number of depressive episodes (mean: 3.36; SD: 5.51). The mean numbers of total lifetime episodes were 8.58 (10.6%). When the number of episodes per year was computed, the mean number of manic episodes per year exceeded that of the mean number of depressive episodes. Compared to females, a higher proportion of males had a history of comorbid substance dependence. LIMITATIONS The course was assessed retrospectively and the study was limited to participants attending the outpatient clinics. CONCLUSIONS The course of BD in India differs from that described from developed countries in the form of a number of manic episodes exceeding the depressive episodes.
Indian Journal of Mental Health(IJMH), 2016
Journal of Geriatric Mental Health, 2019
Aim of the Study: This study aimed to evaluate the prevalence and risk factors for suicidal ideat... more Aim of the Study: This study aimed to evaluate the prevalence and risk factors for suicidal ideations (SIs) and suicidal attempts (SAs) among elderly patients with depression, seeking treatment in psychiatric setups. Methodology: The study sample comprised 488 elderly patients (age ≥60 years) with depression recruited across eight centers. These patients were evaluated on the Columbia Suicide Severity Rating Scale, Geriatric Depression Scale-30, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-15 Scale, UCLA Loneliness Scale, Revised Social Connectedness Scale, and Montreal Cognitive Assessment Scale. Results: “Wish to die” was present in one-fifth (21.7%) and about one-fourth (26.6%) of the study samples at the time of assessment and in the lifetime, respectively. Overall, one-fourth (25.8%; n = 126) of the participants had SIs at the time of assessment and two-fifths (41.5%; n = 203) had SIs in the lifetime. Overall, about one-tenth (9.2%) of the participants made an SA just before assessment and one-sixth (16.6%) had at least one SA in the lifetime. Compared to those with no SIs in the lifetime, those with current and lifetime SIs had lower age of onset and longer duration of illness, less often had a comorbid physical illness, more often had recurrent depressive disorder, had significantly higher anxiety as assessed on GAD-7 scale, and had significantly higher prevalence of loneliness and significantly higher prevalence of cognitive deficits. When those with any current and lifetime SAs and those with no lifetime SAs were compared, those with SAs had longer duration of current treatment and more often had comorbid physical illness and significantly higher cognitive deficits. Conclusions: The present study suggests that about one-fourth (25.8%) of the elderly with depression have SIs at the time of assessment and about two-fifths (41.5%) have lifetime SIs. About one-sixth of the elderly patients with depression make at least one SA in the lifetime and about one-tenth attempt suicide in recent past. In terms of risk factors for SIs and SAs, the present study suggests that the presence of comorbid anxiety, loneliness, and cognitive deficits possibly predispose the elderly to suicidal behaviors.
Journal of Geriatric Mental Health, 2018
Aim of the Study: This study aims to evaluate the prevalence of physical comorbidities and prescr... more Aim of the Study: This study aims to evaluate the prevalence of physical comorbidities and prescription patterns in elderly patients with depression. Materials and Methods: This study included 488 elderly patients (aged ≥60 years) with depression recruited across eight centers. A self-designed physical comorbidity checklist was used to assess for the presence of various physical comorbidities and prescription of psychotropic medications was recorded. Results: More than three-fourth of the study sample (n = 384; 78.7%) had at least one physical comorbidities and one-third (36.7%) of the samples had at least three physical illnesses. About half of the study samples had hypertension (47.3%) and slightly more than one-fourth had diabetes mellitus (29%). The most common physical illness involved the cardiovascular system (51.5%), followed by endocrinological system (39.3%), orthopedic and joint-related diseases (35%), and ophthalmological problems (22.3%). Those with physical comorbidity had higher severity of depression, anxiety, and somatic symptom. Sertraline was the most preferred antidepressant followed by escitalopram and mirtazapine. Only 12.7% of the sample was prescribed antipsychotics of which quetiapine and olanzapine were the most commonly used agents. Benzodiazepines were prescribed to more than half of the study samples (56.55%), with clonazepam being the most preferred benzodiazepine followed by lorazepam. Compared to those without hypertension, those with hypertension were more commonly prescribed sertraline and escitalopram and less commonly prescribed fluoxetine. Similarly, compared to those without diabetes mellitus, those with diabetes mellitus were more commonly prescribed sertraline and less commonly prescribed fluoxetine. Conclusion: Comorbid physical illnesses are highly prevalent in elderly participants with depression with hypertension being the most common physical comorbidity followed by diabetes mellitus and osteoarthritis. The presence of physical comorbidity is associated with more frequent prescription of sertraline and escitalopram.
Journal of Geriatric Mental Health, 2018
Aim of the Study: To assess the symptom profile of depression among elderly patients presenting t... more Aim of the Study: To assess the symptom profile of depression among elderly patients presenting to psychiatric outpatient settings. An additional aim was to evaluate the influence of gender, age of onset, age at presentation, and type of episode (i.e., the first episode versus recurrent depressive episodes) on symptom profile of geriatric depression. Materials and Methods: This multicentric study was conducted at eight centers in which 488 elderly patients (aged ≥60 years) with depression were evaluated on Geriatric Depression Scale (GDS-30), Generalized Anxiety Disorder-7 Scale (GAD-7), Patient Health Questionnaire-15 (PHQ-15) scale, and Columbia Suicide Severity Rating Scale. Results: Males had significantly higher prevalence of comorbid substance dependence, whereas females had significantly higher prevalence of comorbid psychiatric disorders. As per the GDS-30, about two-third or more of the study sample had symptoms of feeling helpless (71.7%), often getting restless and fidgety (70.1%), dropped many of their activities (68.4%), frequently feel like crying (67.4%), trouble concentrating (67%), feels pretty worthless (66.4%), often feeling downhearted and blue (65.8%), frequently getting upset over little things (64.8%), and not satisfied with life (62.9%). More than two-third of the sample had all the symptoms of anxiety as per the GAD-7 and 7 out of the 14 somatic symptoms as per the PHQ-15. When comparisons were made between males and females, significant difference in prevalence was noted for some of the depressive symptoms as assessed by the GDS-30 and somatic symptoms as assessed by the PHQ-15, but no differences emerged in terms of anxiety symptoms. Significantly higher proportion of females reported active suicidal ideation with specific plan and intent and had higher intensity of suicidal ideations. Differences in symptom profile were also noted with regard to age of onset (<60 and ≥60 years), age at presentation (<70 and ≥70 years), and type of depression (single versus multiple episodes). Conclusion: The present study suggests that somatic and anxiety symptoms are highly prevalent among elderly patients with depression. Further, it is evident that there are certain differences in the symptom profile of depression among male and female patients with depression. The present study also reveals that age of onset, age at presentation, and number of episodes could also influence the symptom profile of depression among the elderly.
European Polymer Journal, 2019
Abstract We describe the sequential incorporation of the quaternized monomer N-(2-(Methacryloylox... more Abstract We describe the sequential incorporation of the quaternized monomer N-(2-(Methacryloyloxy)ethyl)-N,N-dimethylheptan-1-ammonium (QDM) (from 1 up to 5 mol %) into 2-((dimethylamino)ethyl methacrylate) polymer chains (PDMAEMA), via reversible addition-fragmentation chain transfer (RAFT) technique, to yield quasi-block copolymers (PDMAEMA-qb-P(DMAEMA-co-QDM)) with modified hydrophilic nature and thermo-induced self-assembly properties in aqueous solutions. This chemical modification promotes the formation of metastable nanostructures in aqueous medium. The morphological transitions were investigated by means of atomic force microscopy (AFM), dynamic light scattering (DLS), rheology and turbidimetry. The results indicated that the obtained nanostructures were stabilized by associative and cationic interactions conveyed by the quaternized moieties within the polymer chains. The size of these nanostructures could be modified as a function of molar mass, copolymer composition and temperature. The method described denotes an interesting alternative to modify the thermo-induced self-assembly behavior of PDMAEMA based copolymers employing low amounts of quaternized moieties.
Indian Journal of Mental Health(IJMH), 2016
Background: Mental illness is a major contributor to global disease burden and this is expected t... more Background: Mental illness is a major contributor to global disease burden and this is expected to increase over years. In community mental illness has not been well understood by the lay persons, resulting in stigmatizing attitudes towards persons with mental illness and mentally ill. High mental health literacy which includes adequate knowledge and positive attitudes in college students towards psychiatric illnesses would benefit society at large. Aims: Aim of the study was to assess knowledge and attitude of college students of Medical, Arts Faculties towards the mentally ill and socio-demographic correlates using CAMI subscales. Methodology: Medical college and Arts colleges were surveyed Cross Sectionally regarding students' attitude towards psychiatric illness using the Community Attitude towards the Mentally Ill (CAMI) scale. Totally 1231 Students' responses were analyzed using appropriate statistical methods on SPSS version 15.0. Results: On CAMI scale, students had positive attitudes for Benevolence subscale & Community Mental Health Ideology Subscale. There was a mixed response on Social Restrictiveness subscale and negative attitude was found on Authoritarianism subscale in majority items. Significant differences were observed in attitude towards mentally ill by gender, faculty of education, family type and domicile. Conclusions: These results suggest that widespread educational campaigns need to be implemented across the college students to increase knowledge about mental illness and reduce stigma towards mental illness and mentally ill persons by educational interventions and training which will benefit community at large.
Journal of Geriatric Mental Health, 2018
Aim of the Study: This study aimed to evaluate the prevalence of loneliness and its relationship ... more Aim of the Study: This study aimed to evaluate the prevalence of loneliness and its relationship with social connectedness and depression in elderly. Additional aims were to evaluate the demographic and clinical factors associated with loneliness and social connectedness in elderly patients with depression. Methodology: The study sample comprised 488 elderly patients (age ≥60 years) with depression recruited across 8 centers. These patients were evaluated on Geriatric Depression Scale (GDS-30), Generalized Anxiety Disorder-7 Scale (GAD-7), Patient Health Questionnaire-15 (PHQ-15) Scale, Columbia Suicide Severity Rating Scale, UCLA Loneliness Scale (LS), and Revised Social Connectedness Scale. Results: About three-fourth (77.3%) of the entire sample reported the presence of loneliness. With respect to specific loneliness symptom, 62.5% reported lack of companionship, 58.7% reported being left out in life, and 56.5% of the individuals reported felt isolated from others. No gender differences were noted in the prevalence of any loneliness symptom. Higher loneliness scores had significant positive correlation with severity of depression, anxiety, and somatic symptoms as assessed by GDS-30, PHQ-15, and GAD-7, respectively, in individuals of both the genders. Higher social connectedness was associated with higher level of anxiety and lower loneliness in females only. Being currently single, older age, longer duration of illness, presence of family history of mental illness, presence of comorbid physical illness, and absence of substance abuse were associated with higher loneliness. With regard to suicidality, higher loneliness was associated with nonspecific active suicidal thoughts, active suicidal ideations with and without intent, nonsuicidal behavior, and higher intensity of suicidal ideations. Conclusions: About three-fourth of the elderly patients with depression also have associated loneliness. Loneliness is associated with higher severity of depression, anxiety, and somatic symptoms. Severity of depression is associated with loneliness but not with social connectedness. Lower social connectedness among elderly females with depression is associated with higher loneliness, but this is not true for elderly males with depression.
Psychiatry Research, 2017
The International journal of social psychiatry, 2017
Stigma is very common among caregivers of patients with severe mental disorder; however, there is... more Stigma is very common among caregivers of patients with severe mental disorder; however, there is lack of national level data from India. To assess affiliate stigma and its correlates among caregivers of patients with severe mental disorders. For this, caregivers of patients with schizophrenia ( N = 707), bipolar disorder ( N = 344) and recurrent depressive disorder ( N = 352) were assessed on Stigma scale for Caregivers of People with Mental Illness and General Health Questionnaire. Caregivers of patients with schizophrenia reported significantly higher stigma than patients with bipolar disorder and recurrent depressive disorder. Caregiver of patients with bipolar disorder reported significantly greater stigma than the caregivers of patients with recurrent depressive disorder. Higher caregiver stigma in all the diagnostic groups was associated with higher psychological morbidity in caregivers. Higher stigma in caregivers of schizophrenia was seen when the patient had younger age of...
The International journal of social psychiatry, Jan 3, 2015
To assess the phenomenology and associated beliefs in patients with Dhat syndrome. A total of 780... more To assess the phenomenology and associated beliefs in patients with Dhat syndrome. A total of 780 male patients aged more than 16 years were recruited from 15 centers spread across the country and were assessed on Dhat Syndrome Questionnaire. The most commonly reported reasons for passage of Dhat were excessive masturbation (55.1%), sexual dreams (47.3%), excessive sexual desire (42.8%) and consumption of high energy foods (36.7%). The most common situation in which participants experienced passage of Dhat were as 'night falls' (60.1%) and 'while passing stools' (59.5%). The most common consequence due to passage of Dhat was weakness in sexual ability (75.6%). In terms of psychological and somatic symptoms, the common symptoms included bodily weakness (78.2%); feeling tired or having low energy (75.9%); feeling down, depressed, or hopeless (67.9%); and little interest or pleasure in doing things (63.7%). In terms of treatment expectations, about half of the patients ...
The Journal of Sexual Medicine, 2015
There are limited numbers of studies on Dhat syndrome. Major limitations of the existing literatu... more There are limited numbers of studies on Dhat syndrome. Major limitations of the existing literature are heterogeneous assessment methods used to describe the comorbidity and small sample size from isolated centers. To assess comorbidity with a common methodology in patients with Dhat syndrome from multiple centers across India. Using a cross-sectional design, this multicentric study involved assessment of 780 male patients, aged more than 16 years, across 15 study centers. ICD-10 criteria (for evaluation of psychiatric morbidity and sexual dysfunction) RESULTS: About one-third (32.8%) of the cases had no comorbidity. One-fifth (20.5%) of the patients had comorbid depressive disorders and another one-fifth (20.5%) had comorbid neurotic, stress-related and somatoform disorders. Half (51.3%) of the study sample had comorbid sexual dysfunction. When various combinations of comorbidities were evaluated, it was seen that more than one-fourth (28.7%) of the patients had only comorbid sexual dysfunction and one-sixth (15.9%) had only comorbid depressive/anxiety disorders. A little more than one-fifth (22.6%) had comorbidity of both sexual dysfunction and depressive/anxiety disorders. Comorbid sexual dysfunction is seen in half of the cases of Dhat syndrome, and it is more common than comorbid depressive and anxiety disorders. Grover S, Avasthi A, Gupta S, Dan A, Neogi R, Behere PB, Lakdawala B, Tripathi A, Chakraborty K, Sinha V, Bhatia MS, Pattojoshi A, Rao TSS, and Rozatkar A. Comorbidity in patients with Dhat syndrome: A nationwide multicentric study. J Sex Med **;**:**-**.
Indian Journal of Psychiatry, 2015