Effectiveness of therapeutic milieu intervention on inpatients with depressive disorder: A feasibility study from North India

Author(s):  
Xavier Belsiyal Chellappan ◽  
Sreevani Rentala ◽  
Anindya Das
Author(s):  
Ravdeep Kaur ◽  
Tarundeep Singh ◽  
Shubh Mohan Singh ◽  
Rajesh Kumar

Background: Study explores relationship between depressive disorder and adherence to DOTS (Directly Observed Therapy Short Course) and whether treatment of depressive disorder according to severity of depressive disorder should be an option to improve adherence to DOTS.Methods: Study included 182 newly diagnosed adult cases of tuberculosis who were on anti- tuberculosis therapy (ATT) as per program guidelines and were in third month under DOTS category I and category II therapy. Patients were screened for depressive and anxiety disorder using PHQ-9 and GAD-7. Modified ACTG baseline questionnaire was used to collect data about adherence and reasons for partial adherence.Results: Overall prevalence of depressive disorder amongst participants was found to be 37.9% and that of partial adherence (missed two or more than two doses) was 12.1%. Partial adherence was mostly seen in the first month, followed by third and second month of DOTS. Twenty- two percent patients with depressive disorder were partially adherent to ATT. Odds ratio suggests higher risk being partially adherent to ATT were greater in the participants who had depressive disorder.Conclusions: This study highlights the benefit of screening patients while diagnosing tuberculosis patients for depressive disorder, to improve disease outcome and reduce likelihood of MDR-TB.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e052312
Author(s):  
Wei Lee ◽  
Caitlin Sheehan ◽  
Richard Chye ◽  
Sungwon Chang ◽  
Colleen Loo ◽  
...  

IntroductionMajor depressive disorder (MDD) in people with advanced life-limiting illnesses can have significant impact on the quality-of-life of those affected. The management of MDD in the palliative care setting can be challenging as typical antidepressants may not work in time nor be tolerated due to coexisting organ dysfunctions, symptom burden and frailty. Parenteral ketamine was found to exhibit effective and rapid-onset antidepressant effect even against treatment-resistant depression in the psychiatric population. However, there is currently neither feasibility study nor available prospective study available to inform of the safety, tolerability and efficacy of such for MDD in the palliative setting.Methods and analysisThis is an open-labelled, single arm, phase II pilot feasibility study involving adult patients with advanced life-limiting illnesses and MDD across four palliative care services in Australia. It has an individual dose-titration design (0.1–0.4 mg/kg) with weekly treatments of subcutaneous ketamine infusion over 2 hours. The primary outcome is feasibility. The secondary outcomes are related to the safety, tolerability and antidepressant efficacy of ketamine, participants’ satisfaction in relation to the trial process and the reasons for not completing the study at various stages. The feasibility data will be reported using descriptive statistics. Meanwhile, side effects, tolerability and efficacy data will be analysed using change of assessment scores from baseline.Ethics and disseminationEthics approval was acquired (South Western Sydney Local Health District: HREC/18/LPOOL/466). The results of this study will be submitted for publication in peer-reviewed journals and presented at relevant conferences.Trial registration numberAustralian New Zealand Clinical Trial Registry Number: ACTRN12618001586202; Pre-results.


2020 ◽  
Vol 22 (3) ◽  
Author(s):  
Ashok Seshadri ◽  
Matthew M. Clark ◽  
Simon Kung ◽  
Matthew Fuller-Tyszkiewicz ◽  
Amit Sood ◽  
...  

2011 ◽  
Vol 12 (03) ◽  
pp. 255-265 ◽  
Author(s):  
C. Jane Morrell ◽  
Stephen Curran ◽  
Annie Topping ◽  
Kauserjan Shaik ◽  
Venkatesh Muthukrishnan ◽  
...  

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