D.K. Subbakrishna

Antidepressant efficacy of Sudarshan Kriya Yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine

BACKGROUND Sudarshan Kriya Yoga (SKY) is a procedure that involves essentially rhythmic hyperventilation at different rates of breathing. The antidepressant efficacy of SKY was demonstrated in dysthymia in a prospective, open clinical trial. This study compared the relative antidepressant efficacy of SKY in melancholia with two of the current standard treatments, electroconvulsive therapy (ECT) and imipramine (IMN). METHODS Consenting, untreated melancholic depressives (n=45) were hospitalized and randomized equally into three treatment groups. They were assessed at recruitment and weekly thereafter for four weeks. RESULTS Significant reductions in the total scores on Beck Depression Inventory (BDI) and Hamilton Rating Scale for Depression (HRSD) occurred on successive occasions in all three groups. The groups, however, did not differ. Significant interaction between the groups and occasion of assessment occurred. At week three, the SKY group had higher scores than the ECT group but was not different from the IMN group. Remission (total HRSD score of seven or less) rates at the end of the trial were 93, 73 and 67% in the ECT, IMN and SKY groups, respectively. No clinically significant side effects were observed. DISCUSSION Within the limitations of the design (lack of double blind conditions), it can be concluded that, although inferior to ECT, SKY can be a potential alternative to drugs in melancholia as a first line treatment.

Religious coping and psychological wellbeing in carers of relatives with schizophrenia

Objective: To examine the use of religious coping and its relation to psychological wellbeing in carers of relatives with schizophrenia.

Effect of yoga therapy on facial emotion recognition deficits, symptoms and functioning in patients with schizophrenia.

Behere RV, Arasappa R, Jagannathan A, Varambally S, Venkatasubramanian G, Thirthalli J, Subbakrishna DK, Nagendra HR, Gangadhar BN. Effect of yoga therapy on facial emotion recognition deficits, symptoms and functioning in patients with schizophrenia.

Neurological soft signs in never-treated schizophrenia

Objective: Studies of Neurological Soft Signs (NSS) in schizophrenia are confounded by handedness, inconsistent methodology, and prior treatment with neuroleptics. The study objective is to examine NSS in never‐treated schizophrenia.

P300 amplitude and antidepressant response to Sudarshan Kriya Yoga (SKY)

BACKGROUND There is evidence that Sudarshan Kriya Yoga (SKY) has significant antidepressant effects. OBJECTIVE The present study examined whether pretreatment P300 ERP amplitude predicts antidepressant response to SKY. METHODS Consenting, drug-free depressed patients (n = 30; dysthymics, 15, melancholics, 15) who received SKY as the sole treatment were assessed clinically at pretreatment, 1 month and 3 months. Auditory P300 was recorded before treatment. RESULTS Twenty-two patients responded favourably to SKY. The pretreatment P300 amplitude neither distinguished responders and non-responders nor was associated with differential rates of response. DISCUSSION It is concluded that SKY therapy is uniformly effective regardless of the pretreatment P300 amplitude.

The Social Occupational Functioning Scale (SOFS): A brief measure of functional status in persons with schizophrenia

The social functioning of persons with schizophrenia contributes to their overall functional outcome and ability to live in the community. Enhancing the level of social functioning is an important treatment goal. The present study describes the development of the Social Occupational Functioning Scale (SOFS), a brief, yet comprehensive, easy to administer measure of social functioning for use in busy clinical settings. It has adequate psychometric properties in terms of reliability and validity. Exploratory factor analysis revealed a three-factor structure comprising of adaptive living skills, social appropriateness and interpersonal skills, accounting for 59% of the variance in total SOFS score.

Sex difference in age at onset of schizophrenia: discrepant findings from India.

Consecutive male (n=100) and female (n= 100) DSM‐IV schizophrenics newly registered for treatment in a large psychiatric hospital were examined with regard to age at onset of the first psychotic symptom. Age at onset of the first psychotic symptom did not differ between the sexes regardless of whether schizophrenia was diagnosed by DSM‐IV or by several alternative systems. Age at onset defined by other criteria, namely age at first contact with a physician, and age at first admission for psychiatric care, also did not show any differences between the sexes. Survival analysis of subjects having a documented date of birth revealed a female preponderance at younger ages. A higher positive symptom score predicted older age at onset of the first psychotic symptom in the total sample. These findings call into question the universality of the traditional view of a younger age at onset of schizophrenia among males. Tentative neurodevelopmental and cultural explanations are presented to explain why there is no sex difference in age at onset of schizophrenia in India.

Prospective comparison of course of disability in antipsychotic-treated and untreated schizophrenia patients.

Objective:  To compare the course of disability in schizophrenia patients receiving antipsychotics and those remaining untreated in a rural community.

Coping and Subjective Wellbeing in Women with Multiple Roles

Background: Married, working women experience a considerable amount of strain from their multiple roles. At the same time, studies indicate that they enjoy a high level of wellbeing. While the nature of employment and the level of spousal support have been examined in relation to wellbeing, the role of coping styles has not received much attention. Aim: To examine the role of work-related factors, availability of support and coping styles as predictors of wellbeing. Method: Sixty married, working women were individually interviewed with regard to reasons for employment and support availability, and administered the Coping Checklist and Subjective Wellbeing Inventory. Results: On stepwise multiple regression analysis, greater use of social support seeking and less use of denial as coping styles, absence of multiple role strain, working to be financially independent, availability of support and refusal of job promotion were significant predictors of wellbeing. Conclusion: In working women with multiple roles, enhancing problem and emotion focused coping by strengthening the use of the support network is important for wellbeing.

Therapeutic efficacy of add-on yogasana intervention in stabilized outpatient schizophrenia: Randomized controlled comparison with exercise and waitlist.

Background: Schizophrenia is a highly disabling illness. Previous studies have shown yoga to be a feasible add-on therapy in schizophrenia. Aims: The current study aimed to test the efficacy of yoga as an add-on treatment in outpatients with schizophrenia. Settings and Design: The study done at a tertiary psychiatry center used a single blind randomized controlled design with active control and waitlist groups. Materials and Methods: Consenting patients with schizophrenia were randomized into yoga, exercise, or waitlist group. They continued to receive pharmacological therapy that was unchanged during the study. Patients in the yoga or exercise group were offered supervised daily procedures for one month. All patients were assessed by a blind rater at the start of the intervention and at the end of 4 months. Results: Kendall tau, a nonparametric statistical test, showed that significantly more patients in the yoga group improved in Positive and Negative Syndrome Scale (PANSS) negative and total PANSS scores as well as social functioning scores compared with the exercise and waitlist group. Odds ratio analysis showed that the likelihood of improvement in yoga group in terms of negative symptoms was about five times greater than either the exercise or waitlist groups. Conclusion: In schizophrenia patients with several years of illness and on stabilized pharmacological therapy, one-month training followed by three months of home practices of yoga as an add-on treatment offered significant advantage over exercise or treatment as usual. Yoga holds promise as a complementary intervention in the management of schizophrenia.