Publications by authors named "Jagadisha Thirthalli"

Background: The bidirectional phenomenon of homelessness and Mental Illness (MI) creates a vicious circle that is hard to escape. In India, Homeless Women with Severe Mental Illness (HWSMI) often rely on institutional care due to the absence of family or community alternatives, which distances them from socio-economic, cultural, political resources and the right to live with dignity. Hence, there is a need to develop a model that will help reintegrate HWSMI into the community.

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Background: Depression is a common mental health disorder with a wide treatment gap despite the availability of a number of effective treatment options. Blended interventions adopt a novel approach in combining internet-based self-help with brief face-to-face sessions thereby combining the advantages of both approaches and offering scope to address the treatment gap. The present study examined the effectiveness of a blended intervention combining the use of guided internet-based self-help with four to six face-to-face sessions in the treatment of mild to moderate depression.

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Background: A healthy lifestyle is important for recovery, coping with life's stresses, minimizing the occurrence and impact of health issues, and improving quality of life. Maintaining a healthy lifestyle may help in preventing or delaying the onset of many health problems.

Methods: A quantitative research approach with a randomized control trial (RCT) was adopted.

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We aimed to assess the incremental value of schizophrenia polygenic risk score (PgRS) and resting-state functional brain connectivity (rsFC) when added to clinical data in predicting the six-week response to oral risperidone (Risperdal) in schizophrenia. Fifty-seven, 54, and 43 individuals in a group of never-before-treated first-episode schizophrenia had good quality whole-genome sequencing (10x), rsFC, and both genomic and rsFC data, respectively, at baseline. Symptom severity ratings were obtained at baseline and six-weeks of oral risperidone (Risperdal) treatment.

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Background: Major psychiatric illnesses often cluster in families, and their impact on affected and unaffected members within families may reflect the consequence of both genetic and social liability.

Methods: Data was derived from 202 families with multiple affected individuals. Affected individuals (N = 259) had a diagnosis of schizophrenia, bipolar disorder, obsessive-compulsive disorder or substance use disorder.

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Background: In the Indian context, published systematic research on the opinions of mental health professionals and other stakeholders (patients and caregivers) regarding the different adverse effects of electroconvulsive therapy (ECT) is not available. This type of study allows for an in-depth exploration of complex phenomena, such as the perspectives of mental health professionals, which can provide a rich understanding of their experiences regarding ECT and also helps to understand the views of mental health professionals regarding the adverse effects of ECT during the post-ECT recovery period and its management. Conversely, the perception of patients and caregivers regarding the adverse effects of ECT can provide a more comprehensive understanding of the treatment and its impact on the patients who receive it.

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Background: An estimated 200 million Indians have mental health conditions - a sizeable proportion of them requiring psychiatric rehabilitation services. The numbers of mental health professionals are abysmally low. Early psycho-social rehabilitation interventions can improve functional outcomes, reducing disability.

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Traditional cognitive assessments in schizophrenia are time-consuming and necessitate specialized training, making routine evaluation challenging. To overcome these limitations, this study investigates the feasibility and advantages of utilizing smartphone-based assessments to capture both cognitive functioning and digital phenotyping data and compare these results to gold standard measures. We conducted a secondary analysis of data from 76 individuals with schizophrenia, who were recruited across three sites (one in Boston, two in India) was conducted.

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Article Synopsis
  • - The study investigates why individuals with schizophrenia and their caregivers often do not seek psychiatric treatment, identifying various barriers to access.
  • - Researchers interviewed 67 individuals with schizophrenia and their families, using a tool called SOFIAc, and found 10 factors that contributed to their lack of access to treatment.
  • - Key barriers included distance to treatment centers, knowledge and attitudes towards psychosis, financial issues, lack of insight into their condition, and family support dynamics, highlighting the complex nature of the problem.
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The investigational potential of TMS in psychiatry is largely underutilized. In the current article, we present the results of five studies with similar TMS protocols that looked at the investigative applications of TMS via measuring cortical reactivity as potential biomarkers in mood disorders. The first two studies, evaluate potential of TMS parameters and Motor neuron system (MNS) as state or trait markers of BD.

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Background: There is increasing evidence of the need for treatment engagement between Persons with Severe Mental Illnesses (PwSMIs) and Mental Health Professionals (MHPs). This therapeutic process involves collaborative work between patients and MHPs, which improves the condition. Community nurses are uniquely positioned to facilitate this process as they act as the focal point of interaction between patients and the health system.

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Electroconvulsive therapy (ECT) is one of the most effective treatments in psychiatry. However, it has many cognitive and non-cognitive adverse effects (AEs). There are lacunae in the literature on systematic assessment of non-cognitive AEs.

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Background: Identifying stable and consistent resting-state functional connectivity patterns across illness trajectories has the potential to be considered fundamental to the pathophysiology of schizophrenia. We aimed to identify consistent resting-state functional connectivity patterns across heterogeneous schizophrenia groups defined based on treatment response.

Methods: In phase 1, we used a cross-sectional case-control design to characterize and compare stable independent component networks from resting-state functional magnetic resonance imaging scans of antipsychotic-naïve participants with first-episode schizophrenia (n = 54) and healthy participants (n = 43); we also examined associations with symptoms, cognition, and disability.

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Article Synopsis
  • - The manuscript advocates for manufacturers to create a standard for electroconvulsive therapy (ECT) devices in India for improved regulation.
  • - This push is particularly important following the 2017 medical devices rules that classified ECT as Class C and the US-FDA's change in ECT device classification in 2018.
  • - Implementing these standards aims to enhance both the quality of ECT devices and the practices involved in administering ECT.
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Individualized lifestyle interventions using motivational interviewing (MI) approach are recommended for persons with severe mental illness (SMI) for effective weight management. The aim of this meta-analysis was to assess the effectiveness of various lifestyle interventions that addressed obesity among persons with SMI. Twelve RCTs were assessed by individual reviewers using revised cochrane risk-of-bias tool (RoB 2).

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Background: A good number of psychiatric patients continue to stay in psychiatric hospitals for longer period of time despite their recovery. Inevitably, they tend to experience limitations to their freedom, personal choice and social isolation, and loss of self. It is important to assess the characteristics of these patients and the challenges in social integration.

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Mental disorders in India form a major public health concern and the efforts to tackle these dates back to four decades, by way of the National Mental Health Programme (NMHP) and its operational arm, the District Mental Health Programme (DMHP). Although the progress of NMHP (and DMHP) was relatively slower till recently, the last 4-5 years have seen rapid strides with several initiatives, including (i) expansion of DMHPs to 90 per cent of the total districts of the country, (ii) the National Mental Health Policy and (iii) strengthening the Mental Health Legislation by way of providing explicit provisions for rights of persons with mental illnesses. Among others, factors responsible for this accelerated growth include the easily accessible digital technology as well as judicial activism.

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Background: Identifying biomarkers of response to transcranial magnetic stimulation (TMS) in treatment-resistant depression is a priority for personalizing care. Clinical and neurobiological determinants of treatment response to TMS, while promising, have limited scalability. Therefore, evaluating novel, technologically driven, and potentially scalable biomarkers, such as digital phenotyping, is necessary.

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