Anindya Das
@aiimsrishikesh.edu.in/a1_1
Additional Professor
All India Institute of Medical Sciences, Rishikesh
RESEARCH, TEACHING, or OTHER INTERESTS
Psychiatry and Mental health
Scopus Publications
Scopus Publications
Jaiganesh Selvapandiyan, Anindya Das, and Gurvinder Pal Singh
Medknow
We systematically reviewed empirical studies of psychotherapy with Indian clients. We defined psychotherapy as an intervention aimed at treating mental disorders using “talk,” which, in a professional medical setting, along with the therapeutic relationship, acquires medicinal value. Besides manual searches in three leading Indian psychiatry journals, we conducted digital searches in PubMed, Google Scholar, and Scopus databases. We found that the commonly practiced evidence-based psychotherapy in India follows the cognitive-behavioral model. Our findings suggest several replication studies which claimed to have used the well-established western models of cognitive behavioural paradigm but have mostly focused on basic behavioural techniques in their protocol. A few innovations were observed, and several essential errors were noted. Innovations include contextual modifications to address the difficulties and challenges faced in service delivery, while errors include deviations from protocol without adequate rationale.
Anindya Das, Apoorva Chaudhary, and Lakshya Tyagi
Springer Science and Business Media LLC
Rohit Kumar, Vijay Krishnan, Anindya Das, Niraj Kumar, and Ravi Gupta
Medknow
Abstract Background: Diagnostic questionnaire that are available for restless legs syndrome does not include items related to RLS mimics and, hence, increases chances of false positive cases. This study aimed at modification and validation of RLS-diagnostic Questionnaire. Methods: During modification, additional items were identified, developed, and subjected to evaluation by experts. Experts were requested to validate the content of each item. Based on their responses, content validity indices (average and universal agreement) were calculated. It was then translated to Hindi and validated in a clinical population that included patients with RLS, somatic symptoms disorder, anxiety, other RLS mimics, and osteoarthritis. In addition, a group of healthy controls was also included. Face, concurrent, and discriminant validities were calculated. Results: Among 209 subjects, nearly 40 subjects had clinical diagnosis of RLS, osteoarthritis, somatic-symptoms-disorder, and anxiety disorder, each. In addition, 16 patients had other RLS mimics (akathisia, varicose veins, BFS, leg-cramps, chronic insomnia) and 30 were healthy controls. After multiple revisions, content validity indices achieved a score of 1 for m-RLS-DQ. Sensitivity and specificity of m-RLS-DQ v. 1.4 for the diagnosis of RLS were 94.9% and 94.1%, respectively. For the diagnosis of RLS, PPV was 78.7%, and NPV was 98.7% with an accuracy of 94.3%. Less than one fourth of participants having chronic insomnia, somatic symptoms disorder, anxiety disorder, and knee osteoarthritis were found to be false positive on m-RLS-DQ; however, none of the healthy controls were found positive on m-RLS-DQ. Concurrent validity with clinical diagnosis of RLS was 0.83 (P < 0.001). Discriminant validity with somatic symptoms disorder was −0.14 (P = 0.03) and with osteoarthritis −0.24 (P < 0.001). Conclusion: m-RLS-DQ is a valid instrument with acceptable psychometric properties, which can be used for the screening as well as diagnosis of RLS in clinical practice and research studies.
A. Thaduri, A. Sehrawat, D. Poonia, Anindya Das, Rajesh Kumar, A. Varghese, L. Chadha, R. Seenivasagam, P. Garg, Deepak Sundryal and M. Gupta
Background: COVID-19 is one of the most unfortunate events seen in the 21st century. Cancer care providers (CCPs) are under immense mental burden due to the unpredictable pandemic and compromised cancer care among patients. The pandemic has taken a toll on caregivers, be it physically, mentally, or psychosocially. Hence, a longitudinal study was planned to evaluate the temporal changes and the impact of COVID-19 on CCPs. Subjects and Methods: A prospective longitudinal study was conducted from May 2020 to October 2020 to assess the pandemic's impact on mental health among CCPs. Depression, Anxiety, and Stress Scale-21 and PCL5 instruments were used to identify the temporal change with pandemic evolution. An online survey was administered at 6-week intervals through e-mail. Quantitative data were presented as mean with standard deviation, and an independent t-test was used to compare the mean score between the three surveys. Categorical variables were presented in percentages, and the Chi-squared test was used to analyze the differences in categorical variables between different surveys. Results: The questionnaire was e-mailed to 240 CCP's; 115 responses were valid. The mean age is 29.9 ± 5.86, 62.6% were male and 27.4% were female, 41.7% were nursing staff, and 58.3% were doctors. Sixty-seven percentage had <5 years of medical experience. Respondents who stayed with family had significant depression levels in the first and third surveys (odds ratio [OR]: 0.37, confidence interval [CI]-0.15–0.91, P = 0.03) and (OR: 0.17, CI-0.026–1.1, P = 0.04). Stress levels were significantly high in the caregivers staying with family in the first survey (OR: 4.38, CI: 1.2–15.7, P = 0.02). On analyzing three surveys, 55 respondents in both the first and second survey and 21, 8, and 17 respondents persisted in having depression, stress, and anxiety. Conclusions: Pandemic has severely affected the mental well-being of CCPs, with more than one-third of them suffering from depression, anxiety, and stress. In any disaster or an unnatural event, time helps the human mind acclimate to new conditions; it is similar to our initial results that show improvement in depression, stress, and anxiety levels with the second survey. It is crucial to assess and address mental health-related problems to ensure health-care workers well-being and deliver quality health care to the patients.
Anindya Das
SAGE Publications
instrument for health systems has two primary purposes: improve performance and encourage accountability, besides allowing judicious health system decision making.3 While choosing a measure that eventually contributes to a composite index, a few crucial elements that need consideration are defining priority areas, avoiding positively correlated measures (as it may lead to “double counting),”3 and data that are robust and part of a routine process. Health outcome measures such as under-five mortality rate or suicide rate are dependent not only on the health service system but also on an extraneous complex of social, cultural, environmental, and political factors. For example, the suicide rate is also determined by employment and livelihood issues, religious beliefs, gender, socioeconomic status, rural– urban differences, etc.4 However, health systems, too, are part of the latter complex. In contrast, inputs and process indicators are contingent on the functioning of the health service systema and are sensitive to change.
Akanksha Roy, Praveen Kumar Singh, Sarama Saha, Anindya Das, and Manisha Naithani
Springer Science and Business Media LLC
Anindya Das and Rohit Kumar
Royal College of Psychiatrists
point out costs because of the length of phase-oriented treatment and its unpredictable non-linear course, they also highlight the costs involved in the training of staff because DID treatment requires specialised skills currently not developed during psychiatrists’ training. They conclude that the evidence for DID should be followed by clinicians and that appropriate treatment will cost less overall than leaving disorders involving pathological dissociation untreated. An important avenue that might reduce treatment length, and therefore treatment costs, is pharmacological intervention. Corrigan & Hull state that medication is of limited value, but to date no double-blind placebo-controlled studies have been performed with the aim to develop evidence-based pharmacotherapy to alleviate pathological dissociative symptoms in DID. However, it has been proposed that kappa-opioid receptor antagonists may be of interest for the selective pharmacological targeting of debilitating dissociative symptoms in post-traumatic stress disorder and trans-diagnostically. Abnormal serotonin neurotransmission in frontal and temporal regions has been found in relation to dissociative amnesia in a positron emission tomography receptor binding study and therefore serotonergic medication might also be of interest to treat pathological dissociative symptoms. In addition, the authors would like to offer the consideration of a glutamate hypothesis for dissociation on the basis of scientific evidence that (a) the glutamatergic agent ketamine induces dissociative symptoms in humans and in animal models, (b) the psychotropic drug lamotrigine can reduce dissociative symptoms induced by ketamine in healthy individuals, (c) glutamatergic hyperactivity could be relevant in the neurobiology of depersonalisation and (d) lamotrigine can be an augmenting treatment to reduce dissociative symptoms in depersonalisation disorder, and (e) anterior cingulate glutamate concentration correlates positively with dissociative symptoms in individuals with borderline personality. Glutamate concentrations in the brain of individuals with pathological dissociation can relatively easily be measured using magnetic resonance spectroscopy, which may provide information on whether glutamate is a neurochemical biomarker of dissociation. Although more has become known about what happens in the dissociated brain and functional neurocorrelates of pathological dissociation are being unravelled, it remains largely unknown how dissociative symptoms are mediated in the brain at a neurotransmitter level. Neurobiological research into the neurochemical biomarkers of pathological dissociation could possibly lead to the development of pharmacological agents that facilitate more rapid symptom alleviation. Although the development of such pharmacological interventions offers a challenge for the scientific community, they are expected to reduce the treatment costs of individuals with DID.
Anindya Das
Medknow
Xavier Belsiyal Chellappan, Sreevani Rentala, and Anindya Das
Hindawi Limited
PURPOSE
This study examined therapeutic milieu interventions on self-esteem, socio-occupational functioning, and depressive symptoms among inpatients with depressive disorders.
METHODS
A pretest-posttest nonequivalent control group quasi-experimental design was adopted. Sixty participants with depression who got admitted to the general hospital psychiatric ward were assigned to a control (Treatment as Usual) group and an experimental (therapeutic milieu intervention) group nonrandomly using a convenience sampling technique. We evaluated the following outcome measures: self-esteem, socio-occupational functioning, and depressive symptoms for both groups at baseline, 4th, 8th, and 12th weeks.
RESULTS
Therapeutic milieu interventions improved self-esteem, socio-occupational functioning, and reduced depressive symptoms. The findings provided initial evidence for practice.
IMPLICATIONS
Psychiatric nurses can implement simple, milieu therapy interventions in any setting, which will enhance the clinical outcomes and socio-occupational functioning of depressive patients.
Jitendra Rohilla, Vishal Dhiman, Vijay Krishnan, Aniruddha Basu, Anindya Das, VikramSingh Rawat, Anil Nishchal, Malay Dave, RamKumar Solanki, Sreeja Sahadevan,et al.
Medknow
Kaustav Kundu, Rohit Kumar, Shubham Jhanwar, and Anindya Das
SAGE Publications
Anindya Das
Springer Science and Business Media LLC
Anindya Das, Vijay Krishnan, Ravi Gupta, Sandeep Grover, and Rajesh Sagar
Medknow
Ravi Gupta, Anindya Das, Vijay Krishnan, Vishal Dhiman, JitendraKumar Rohilla, VikramSingh Rawat, Aniruddha Basu, and Ravi Kant
Medknow
M Kishor, Ravi Gupta, MV Ashok, Mohan Isaac, RakeshK Chaddha, OmPrakash Singh, Henal Shah, Anil Nishchal, Malay Dave, HR Vinay Kumar,et al.
Medknow
Kumar Thamaraiselvan Santhosh, Harshit Hemant Salian, Mrinal Jha, Anita Sharma, Harshit Garg, Khwaja Khayyam, Fareeduzaffer, Aniruddha Basu, Jitendra Kumar Rohilla, Vikram Singh Rawat,et al.
Elsevier BV
Anindya Das
On‐consultation training The training primarily focuses on how to briefly evaluate for psychiatric signs and symptoms and come up with a prescription devoting on an average 5–10 min for each patient. Thus, the focus is primarily pharmacological management as the authors themselves submit. Moreover expecting something more from the PCDs would be lavish. My personal participation with this training has also made it evident that nonavailability of drugs then turn into a major hurdle in the treatment of patients. Considering the PCDs practice in less resourced locales, even private pharmacies do not stock psychotropics. Thus, training in pharmacological management should go hand in hand with ensuring availability of drugs under the DMHP.
Anindya Das
SAGE Publications
The National Mental Health Program (NMHP) of India is rapidly changing. With the setting up of the Mental Health Policy Group (MHPG) and their observations and recommendations, the District Mental Health Program (DMHP), in the 12 Five-Year Plan (FYP), has been considerably revamped, compared with the 11 FYP. Other than the usual outpatient (OP) and inpatient (10 bed) mental health (MH) services, it has spelled out a day care centre for rehabilitation and a residential/long-term continuing care centre (site unspecified, though the MHPG suggests two each per district with a capacity of 25 beds at each facility), with explicit statement for financial support and MH helpline. It has also specified a Central MH Team to supervise/implement the programme and support the Central Mental Health Authority (CMHA). Financial support for the state and CMHA for implementation of the Mental Health Care Act (MHCA), 2017 has also been indicated. Moreover, unlike in the 11 FYP, Information, Education and Communication (IEC) activities are now relatively more concrete, harnessing the potential of different public media. In addition, the 12 FYP has a definitive plan for the Public–Private Partnership (PPP) activities, and delineates areas of participation. The plan for human resource development scheme nearly remains the same but with quantitatively increased financial allocation. In this context, the review article published in this issue analyses the achievements and shortcomings of the NMHP to chart a future course for the program.
Anindya Das and Urvashi Rautela
Medknow
The issue of culture in Indian psychiatry has endured increasing neglect with the burgeoning biological paradigm. This viewpoint debates and demystifies the connotation of “culture” in mainstream psychiatry. As a template to infer dominant thinking in mainstream psychiatry about culture, DLN Murty Rao Oration in 2011, “Indianizing Psychiatry – Is there a case enough?” by Avasthi (2011) (published in the Indian Journal of Psychiatry) has been used. Engaging a broad interdisciplinary view helps unravel the inherent biases in psychiatry and opens up space for analysis of the Indian psyche from a different philosophic tradition and ways of researching it. Effort here is to open up dialog with cultural psychiatry, make efforts to involve traditional and folk therapies, and use available theoretical and empirical resources within cultural psychiatry for a refined practice of psychiatry in India.
Ruchi Dua, Anindya Das, Abhishek Kumar, Sandeep Kumar, Mayank Mishra, and Kapil Sharma
Medknow
Background: Chronic obstructive pulmonary disease (COPD) is a disease with known systemic manifestations including psychiatric comorbidities most commonly being depression and/or anxiety. Studies regarding the association of these psychiatric comorbidities in terms of symptom scores, spirometric variables, and hospitalizations among patients of COPD are lacking, especially in India. Materials and Methods: One hundred and twenty-eight patients of COPD attending the Outpatient Department of AIIMS Rishikesh, and fulfilling inclusion criteria were screened by Hospital Anxiety and Depression Scale, and those who scored above the cutoff underwent psychiatric evaluation using the International Classification of Diseases, Tenth Edition Diagnostic Criteria for Research for confirmation of their diagnosis. All patients were then evaluated by physician-administered questionnaire for symptom scores by Modified Medical Research Council Scale (mMRC) for dyspnea, Hindi-validated Clinical COPD Questionnaire (CCQ), and for functional capacity by 6-min walk distance (6MWD) according to the American Thoracic Society Guidelines. All patients also underwent spirometric evaluation, and postbronchodilator forced expiratory volume in 1 s (FEV1), BODE index (body mass index [BMI], postbronchodilator FEV1, mMRC for dyspnea, 6MWD) and a history of hospitalization/exacerbations over the past 1 year was also obtained. Comparison of symptom scores, functional capacity in terms of 6MWD, history of exacerbations or hospitalizations over preceding 1 year and BODE index between patients of COPD with or without anxiety and/or depression was done. Results: COPD patients with comorbid anxiety and/or depression had higher dyspnea scores and CCQ scores though the proportion of current smokers, BMI, history of hospitalization over the past 1 year, FEV1, and BODE index was not statistically significant between the two groups. Conclusions: Depression is a common comorbidity and leads to higher symptom scores as well as poorer quality of life among COPD patients.