Indian Journal of Psychological Medicine 

About: Indian Journal of Psychological Medicine is an academic journal published by Medknow. The journal publishes majorly in the area(s): Medicine & Mental health. It has an ISSN identifier of 0253-7176. Over the lifetime, 1919 publications have been published receiving 16814 citations.

How to calculate sample size for different study designs in medical research

Abstract: Calculation of exact sample size is an important part of research design. It is very important to understand that different study design need different method of sample size calculation and one formula cannot be used in all designs. In this short review we tried to educate researcher regarding various method of sample size calculation available for different study designs. In this review sample size calculation for most frequently used study designs are mentioned. For genetic and microbiological studies readers are requested to read other sources.

Depression: the disorder and the burden.

Abstract: Byline: M. Reddy Depression, the common psychological disorder, affects about 121 million people worldwide. World Health Organization (WHO) states that depression is the leading cause of disability as measured by Years Lived with Disability (YLDs) and the fourth leading contributor to the global burden of disease. By the year 2020, depression is projected to reach second place in the ranking of Disability Adjusted Life Years (DALY) calculated for all ages. Today, depression already is the second cause of DALYs in the age category 15-44 years. Burden of Disease An estimated 3-4% of India's 100 crore plus population suffers from major mental disorders and about 7-10% of the population suffers from minor depressive disorders. In the southeast Asian region, 11% of DALYs and 27% of YLDs are attributed to neuropsychiatric disease. A review of eight epidemiological studies on depression in South Asia shows that the prevalence in primary care was 26.3%. In the Goa study, the rate of depressive disorders was 46.5% in adult primary care attendees. The above [Table 1] shows that disability due to depression exceeds disability due to all forms of cancer and diabetes mellitus combined, as well as exceeding the disability due to strokes and hypertensive heart diseases.{Table 1} The Global Burden of Disease (GBD) study (GBD 1990 Study) launched by the WHO in the 1990s showed that Depressive disorders account for 3.7% of total DALYs and 10.7% of total YLDs. GBD 2000 study (WHO 2001) showed that depression accounts for 4.46% of total DALYs and 12.1% of total YLDs. This clearly highlights a trend of increasing burden of disability secondary to depression. Suicidality Depression is associated with high suicidality. About 50% of individuals who have committed suicide carried a primary diagnosis of depression. Because mood disorders underlie 50-70% of all suicides, effective treatment of these disorders on a national level should, in principle, drastically reduce this major complication of mood disorders. Indian union health ministry estimates state that 120,000 people commit suicide every year in India. Also over 400,000 people attempt suicide. A significant percentage of people who commit suicide in India (37.8%) are below 30 years of age. Ministry officials state that majority of those committing suicide suffer from depression or mental disorders. Morbidity Exactly 23% of depressed patients report health difficulties severe enough to keep them bedridden. A community sample of patients with MDD demonstrated increased health care utilization in comparison to patients in the general medical setting. Depression is associated with more impairment in occupational and interpersonal functioning in comparison to several common medical illnesses. The cost of depression, particularly the cost in lost work days, is as great as or greater than the cost of many other common medical illnesses. Maternal and Child Health Depression also has a large impact on maternal and child well being. A series of studies from South Asia have demonstrated that early childhood failure to thrive, as indicated by undernutrition and stunting of growth in babies under 1 year, is independently associated with depression in mothers. A study from Pakistan shows that babies of mothers who were depressed during pregnancy and in the postnatal period were more than five times at greater risk for being underweight and stunted at 6 months than babies of non-depressed mothers, even after adjustment for other confounding factors like socioeconomic status. Childhood failure to thrive is a major risk factor for child mortality. Depressed mothers are more likely to cease breastfeeding. Depression during pregnancy is strongly associated with low birth weight. Treatment The outcome of depression can be significantly improved by early detection. A wide range of highly effective treatments including antidepressant medications (at a cheaper cost), somatic therapies and psychotherapeutic interventions is available for the treatment of depression. …

Pain catastrophizing: an updated review.

Abstract: Pain catastrophizing has been described for more than half a century which adversely affects the pain coping behavior and overall prognosis in susceptible individuals when challenged by painful conditions. It is a distinct phenomenon which is characterized by feelings of helplessness, active rumination and excessive magnification of cognitions and feelings toward the painful situation. Susceptible subjects may have certain demographic or psychological predisposition. Various models of pain catastrophizing have been proposed which include attention-bias, schema-activation, communal-coping and appraisal models. Nevertheless, consensus is still lacking as to the true nature and mechanisms for pain catastrophizing. Recent advances in population genomics and noninvasive neuroimaging have helped elucidate the known determinants and neurophysiological correlates behind this potentially disabling behavior.

The Limitations of Online Surveys

Abstract: Online surveys are growing in popularity, perhaps because they are an easy, convenient, and inexpensive means of data collection. Online surveys commonly suffer from two serious methodological limitations: the population to which they are distributed cannot be described, and respondents with biases may select themselves into the sample. Research is of value only when the findings from a sample can be generalized to a meaningful population. When the population addressed by the survey cannot be described, and when the sample is contaminated by respondents with biases, findings from online surveys cannot be generalized and may therefore mislead.

Recovery model of mental illness: a complementary approach to psychiatric care.

Abstract: Byline: K. Jacob Medicine, in keeping with its status in society, always had a paternalistic culture. Doctors listened to patients' concerns, examined them, ordered laboratory investigations, diagnosed disease, prescribed medication and prognosticated about course and outcome. While they did explain the issues to their patients, medical perspectives and opinions guided their decisions. Patients were expected to follow their advice. The prevalent paternalistic culture within the medical profession often dismissed patient perspectives and did not take kindly to objections or different points of view. Psychiatry with its focus on symptoms and functioning developed elaborate assessments, standardized interviews and rating scales to document and monitor psychopathology. These appraisals measured positive and negative psychotic symptoms, depression and anxiety, cognitive deficits, as well as functioning. The early success of psychotropic medication in reducing symptoms of psychosis and ameliorating anxiety and depression led to optimism among mental health professionals that people with these conditions will recover from their mental illness and lead normal lives. Five decades later, mental health professionals accept that a significant proportion of people with mental disorders continue to have persistent and disabling symptoms and are unable to get back to their previous occupations and social roles. However, the quest for newer psychotropic medication also meant a continued focus on residual symptoms and deficits. Psychiatry conceptualised phases of illness into acute, maintenance and continuation domains. It suggested concepts like relapse, recurrence, remission and recovery based on symptoms profiles over time. [sup][1] Psychiatric models tended to view recovery from mental illness similar to that seen in physical diseases. Despite the power, influence and dominance of psychiatric concepts, once taken as standard, they have gradually began to face opposition. [sup][2] The late 20 [sup]th century saw substantial changes in medicine and society. Contradictions between social consensus and individual values and between the larger and pervasive institutional contexts and social policies led to a re-examination of issues. [sup][3] The general discomfort with and opposition to governmental and institutional authority led to a review of perspectives related to mental illness. The empowered and vibrant user movement in the west argued for different perspectives and approaches. The recovery model views mental illness from a perspective radically different from traditional psychiatric approaches. A Different Perspective on Recovery For many people with mental illness, the concept of recovery is about staying in control of their life rather than the elusive state of return to premorbid level of functioning. Such an approach, which does not focus on full symptom resolution but emphasises resilience and control over problems and life, has been called the recovery model. [sup][4],[5],[6] The approach argues against just treating or managing symptoms but focusing on building resilience of people with mental illness and supporting those in emotional distress. While there is no single definition of the concept of recovery for people with mental health problems, there are guiding principles, which emphasise hope and a strong belief that it is possible for people with mental illness can regain a meaningful life, despite persistent symptoms. Recovery is often referred to as a process, an outlook, a vision, a conceptual framework or a guiding principle. There is evidence to suggest that self-management strategies based on the recovery model may have more value than models based on physical health. [sup][4] An analysis of the main themes in recovery based research suggest that the dominant themes from the stakeholder perspectives were identity, the service provision agenda, the social domain, power and control, hope and optimism, risk and responsibility. …