Background:Suicide is a psychiatric emergency. Stressors in life and social variables (like marital status, family, and social support) are among the determinants of suicide. Hopelessness and suicidal intent are among the psychological variables that have shown promise in the prediction of suicide.Aims and Objectives:To assess stressful life events, hopelessness, suicidal intent, and sociodemographic variables in patients of attempted suicide.Materials and Methods:Fifty consecutive patients admitted with attempted suicide were interviewed. Presumptive Stressful Life Event Scale, Beck Hopelessness Scale, and Beck Suicidal Intent Scale were used along with a semistructured pro forma for interview. Data were analyzed with statistical tests.Results:Sixty-six percent of the participants were females, 72% were less than 30 years of age. Sixty-six percent of the patients had stressful life event score between 101 and 200 with the mean score of 127. The stressful life event score in those who considered they are in need of psychiatric help was significantly high. Most of the patients had mild (34%) and moderate (40%) degrees of hopelessness, and the mean score was 9.64. The mean suicidal intent in the participants was 25.14, when correlated with hopelessness score significant positive correlation was found.Conclusion:Lethality of the attempt increases with the increase in hopelessness.
Background:The definitive diagnosis of depression calls for fulfillment of certain criteria in terms of symptoms, severity, and duration, but subthreshold cases are not uncommon. These may evolve to become clinically diagnosable depression preceded by prodrome. The current study was conducted to study prodromal and residual symptoms in depression.Materials and Methods:Eighty follow-up patients of depressive episode (F32, International Classification of Diseases-10) in remission defined by Hamilton Depression Rating Scale score <8 were interviewed. A symptom was identified as prodromal if it appeared at any time before the period of onset of symptoms sufficient to fulfill the criteria to make a diagnosis of depressive episode. Clinical Interview for Depression and Related Syndromes was used to identify the presence of symptoms. Statistical analysis was done with McNemar test and Pearson's Chi-square test using SPSS software version 20.0.Results:The mean age of patients was 41.25 (±8.58) years and the sample was predominately female patients (80%). All the eighty patients had at least one prodromal symptom. The mean duration of prodrome was 115 (±64.46) days. Irritability (45%), insomnia (45%), and reduced energy (43.8%) were the most frequent prodromal symptoms. Frequency of irritability was comparable in prodromal and residual phases of depression (P = 0.074) and significantly associated with a positive family history of depression (P = 0.004).Conclusion:Prodrome is present in most cases of depression lasting from weeks to months. Prodrome is frequented by irritability, anxiety, sleep problems, and fatigability. Irritability is associated with genetic loading of depression and likely to present as residual symptom if it is present in prodromal phase.
Introduction: Electroencephalography (EEG) has been used extensively to study affective disorders. Quantitative spectral analysis of an EEG scan has been used to assess the biological basis of emotional disorders such as depression as well as to investigate biomarkers of affective disorders. Inter-hemispheric asymmetries in both baseline and stimulus-evoked frequencies (alpha, beta, theta, and delta) are potential biomarkers of depression. The role of frontal alpha asymmetry has been established, but other spectral frequencies such as frontal theta remain elusive. We compared the hemispheric differences in frontal theta power in depressed patients and controls before and during listening to music to study the correlation of frontal theta asymmetry with depression. Methods: To determine whether stimulus-evoked frontal theta asymmetry is a biomarker of depression, we compared 23 patients with mild depression (based on the Hamilton Depression Rating Scale) with 17 age-and sex-matched controls by conducting EEG at rest and after listening to Indian classical music. Results: In controls without depression, the mean frontal theta power of the left hemisphere and frontal theta asymmetry increased significantly during music listening. In depressed patients, frontal theta asymmetry was reversed during music listening. Conclusion: Frontal theta asymmetry is a potential biomarker of depression.
Background: Depression, despite being the most common of mental illness lacks any quantifiable and absolute biomarker. Frontal alpha asymmetry (FAA) is proposed as biomarker of depression both in resting and activated state. Yet, the location of extraction of alpha, clinical utility as well as validity of FAA is uncertain. With aim of obtaining clarity on this confusion we conducted this study. Methodology: Electroencephalographic frontal alpha power was calculated in patients of depression (n = 24) and compared with healthy controls (n = 17) for the assessment of FAA. Both groups were studied for resting phase and activation phase changes in FAA. For activation phase, auditory stimuli in the form of Indian classical music were used. Results: Frontal alpha power was measured across FP1, FP2, F3, F4, F7, and F8. Mean powers were compared in resting (before), activated (during) and postactivated resting stage (after). FAA was statistically significant in F7–F8 pair of electrodes and on F7 electrode when compared between cases and controls. Conclusion: Quest for biomarker for depression churned out FAA as frontrunner. Despite of vast amount of research on it, practical utility eludes us. We need to revisit our approach from conventional search of the diagnostic biomarker; as FAA might reflect component of depression but not totally disorder. In our opinion, we are not yet ready for it and have a road ahead to travel.
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