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Psychosocial factors as predictors of functionality in patients of Major Depressive Disorder
India (MSAI) - Sumandeep Vidhyapeet, Vadodara
Dr. Diptangshu Roychowdhary
Dr. Diptangshu Roychowdhary
Type of Research Project
- Clinical Project without Laboratory work
What is the background of the project?
Mental disorders are a major contributor to the burden of disease in all regions of the world, with about 14% of the global burden attributable to neuropsychiatric disorders(1). MDD (Major Depressive Disorder ), also known as unipolar depression, is a serious emotional disease that negatively influences thoughts, feelings, behavior, mood, and physical health and is characterized by the presence of one or more depressive episodes during the patient’s lifetime(2). Major Depressive Disorder is the third leading cause of disability and recognized as a major determinant of disability, mortality, and health care costs (3). This disorder is a common illness worldwide and results from a complex interaction between social, psychological, and biological factors (4). About 4.4% of the total global disability-adjusted life year (DALY) in 2002 was attributed to this disease. Moreover, it is anticipated that Major Depressive Disorder will be the second major cause of disease burden by 2020 (5) and 2030 (6). Depression exerts a significant negative impact on lives and is deemed the fourth leading cause of high DALY rates across the globe. Major Depressive Disorder is also bracketed together with significant disability, mortality, and health care costs in high-income countries (7,8). Patients affected by Major Depressive Disorder are liable to derive less pleasure from their activities, experience weight fluctuation, suffer from sleep disorders, feel weary, experience lapses of concentration, and even feel worthless or guilty. The exact cause of Major Depressive Disorder is unknown, and it is probable that several mechanisms are involved (2,9). However many researchers believe that Major Depressive Disorder is linked to chemical changes in the brain, genetic disorders, or a combination of both. Major Depressive Disorder tends to run in families, but sporadic cases have also been reported (2,3). According to World Health Organization (WHO), depression is the leading cause of disability as measured by Years Lived with Disability (YLDs) and disability due to depression exceeds disability due to all forms of cancer and diabetes mellitus combined, as well as the disability due to stroke and hypertensive heart diseases (10). This clearly highlights paramount burden of disability which occurs secondary to depression. Much of this burden relates to the economic losses suffered (both personal and to society) when people are depressed and by impairment in their quality of life and relationships.
What is the aim of the project?
Psychosocial factors as predictors of functionality in patients of Major Depressive Disorder. 1.To identify the sociodemographic factors. 2.To assess coping in patients of Major Depressive Disorder . 3.To assess stressful life events in patients of Major Depressive Disorder . 4.To assess illness behavior among Major Depressive Disorder patients. 5.To assess the level of functioning in Major Depressive Disorder patients 6.To assess the correlation of psychosocial factors with the level of functioning.
What techniques and methods are used?
Sampling Technique: Patients with newly diagnosed Major Depressive Disorder attending Psychiatry OPD/IPD will be taken consecutively from Dhiraj Hospital, SBKS MI & RC, Piparia, Vadodara. Inclusion criteria: For Major Depressive Disorder patients: •Participants who are willing to give informed written consent for their participation. •Participants included between 18 to 60 years of age of both genders. •Patients with newly diagnosed Major depressive disorder who are treatment Naive. •Patients fulfilling DSM-V criteria for major depressive disorder. Exclusion criteria: For Major Depressive Disorder patients: •Mentally retarded and intellectual disabilities. •Participants with serious medical illness. •Patients with delirium or dementia or other neurological illness. •Patients with any other psychiatric comorbidities and substance use •Participants not able to perform other assessments eg visual and hearing impairment. Method: Prior permission of Sumandeep Vidyapeeth Institutional Ethics Committee (SVIEC) will be taken to start the study. Prior written informed consent from participating patients will be taken. Patients will be assured about confidentiality of their data & will be explained to answer appropriately to the questions. Consecutive patient (Newly Diagnosed) groups having Major Depressive Disorder and treatment naive will be enrolled after confirming Inclusion and exclusion criteria from Psychiatry OPD and IPD setup in Dhiraj Hospital, SBKS MI &RC, Piparia. Diagnoses of Major Depressive Disorder will be confirmed by Structured Clinical Interview of DSM (SCID)-V. The study will be conducted in two legs: Leg 1: All the patients enrolled for this study will fill the Proforma containing demographic and other information and will be assessed for severity of Major Depressive Disorder and psychosocial functioning using the following tools: •Hamilton Depression Rating Scale (HAM-D) •World Health Organization Disability Assessment Scale (WHO-DAS) •Brief Resilience Coping Scale (BRCS) •Holmes and Rahe Social Readjustment Rating Scale (SRRS) •Illness Behavior Questionnaire (IBQ) Leg 2: The visit of leg 1 will be considered as 1st visit and all patients will receive treatment and thereby followed for 6 months. 2nd visit will be at 3 months and 3rd visit will be at 6 months. Following assessments will be done on each visit: •Hamilton Depression Rating Scale (HAM-D) •World Health Organization Disability Assessment Scale (WHO-DAS) •Brief Resilience Coping Scale (BRCS) •Holmes and Rahe Social Readjustment Rating Scale (SRRS) •Illness Behavior Questionnaire (IBQ)
What is the role of the student?
- The student will mainly observe
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- If the project is clinical
- the student will take active part in the clinical examination
- If the project is clinical
- the student will be allowed to work with patients
- The tasks of the student will be performed on his/her own
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
● The student has to actively participate during the data collection. ● The student will be present while detailed history of the patient is taken. ● The student is expected to make rapport with the patient, and get the correct information from the patient in the most unbiased way possible. ● The student is expected to organize the data along with the instructor in order to make the data easier to analyse. ● The student will then also analyse the data thoroughly. ● The student will be asked to form observations from the analysed data. ● The student in the end will be asked to present the observations and findings in front of the faculty and students. ● The student may be asked to make power point presentations of the observed data.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Yes, there will be teaching through lectures, preliminary readings by Dr. Diptangshu
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a presentation - The student will prepare a scientific report
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
The student should have some knowledge about Major Depressive Disorder and also should have read some papers or journals on the topic.
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students
- Prince M; Patel V; Saxena S; et al. No health without mental health. Lancet2007;370:859-877.
- American Psychiatric Association. 4th. Washington; DC: 2000. Diagnostic and Statistical Manual of Mental Disorders.Pp. 4-25.
- UstunTB;Ayuso-Mateos JL; Chatterji S; Mathers C; Murray CJ. Global burden of depressive disorders in the year 2000. Br JPsychiatry. 2004;184:386-92.
- Meyer C. Depressive disorders were the fourth leading cause of global disease burden in the year 2000. Evid Based MentHealth. 2004;7(4);123.
- Murray CJ; Lopez AD. Alternative projections of mortality and disability by cause 1990-2020; Global Burden of Disease Study. Lancet. 1997;349(9064);1498-504.
- Mathers CD; Loncar D. Projections of global mortality and burden of disease from 2002-2030. PLoS Med. 2006;3(11);e442.
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