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Background Post-partum depression (PPD) is the common adverse outcome of child bearing which affects the wellbeing of both mother and newborn and has long-term effects. Hence, reliable potential biological tests for early detection of PPD are essential. Follicle stimulating hormone (FSH) and luteinizing hormone (LH) were associated with depressive disorders and the present study estimated the levels of serum FSH, LH in postpartum depression and explored them as predictive biomarkers in the development of PPD. Methods In this nested case control study done at a tertiary care hospital in South India, 450 postpartum women were screened at 6th week post-delivery for PPD. Socio-demographic and clinical data were recorded and depressive symptoms were assessed using Edinburgh Postnatal Depression Scale (EPDS). Out of 450 subjects screened, 100 women with depressive symptoms were categorized as cases and 100 controls were selected from the remaining subjects matching for age and BMI with cases. Serum levels of FSH and LH were measured using direct competitive immunoassay by chemiluminescene technology. Results Serum LH/FSH ratio was found to be significantly ( p = 0.02) low in PPD women when compared to normal postpartum subjects. We also found a significant negative correlation between LH/FSH ratio and EPDS scores. Based on the receiver operating characteristic curve, the optimal cut-off value for serum of LH/FSH levels in predicting postpartum depression was estimated to be 0.22 mlU/mL with an AUC of 0.598 (95%CI, 0.291–0.859). Conclusion Our study demonstrated that low LH/FSH ratio after delivery was associated with increased risk for the development of PPD. Low LH/FSH ratio at six-week post delivery can be used as a robust biochemical predictor of post-partum depression. [ABSTRACT FROM AUTHOR]

Study aimed to identify association between loneliness, depression and perceived social support in adults living in the empty nest stage of family life cycle and to assess impact of digital technology use on the same. In this hospital based cross-sectional study, we recruited 281 adults aged 50 years and above. Assessment of loneliness and depression was done using University of California Los Angeles Loneliness scale and Patient Health Questionnaire. Social support was assessed using Multidimensional scale of perceived social support. Digital technology use was assessed based on their self -reported use of mobile, or computer. Among the participants (age 50–75 years), women accounted for 57.7%. 71% of the adults were staying with the spouse, 85% of the participants reported lowincome status. Mean score (SD) of loneliness was 61.7(10.23). Only 17.8% were classified as having no to mild depression, while 52.7% reported low social support. Loneliness severity correlated significantly with depression severity (σ = 0.59, p = 0.000), and perceived social support (σ = −0.78, p = 0.000). Use of digital technology (72.9%) was associated with significantly lower loneliness score (U=4120.00, p = 0.000, lower depression score (U=5106.00, p = 0.000) and higher perceived social support (U=4366.00, p = 0.000). Loneliness is present in adults in the empty nest stage of life cycle. Its severity positively correlated with depressive symptoms and negatively with perceived social support. Digital technology users seem to have lower loneliness, lower depression severity and higher social support compared to non-digital technology users. • Study assessed for loneliness in adults (age 50–75 years) in the empty nest stage of the family life cycle. • Mean score (SD) on loneliness scale was 61.7(10.23). • Majority reported depressive symptoms, while 52.7% reported low social support. • Loneliness severity correlated positively with depression severity. • Loneliness severity correlated negatively with perceived social support. • Regular digital technology use was associated with significantly lower loneliness score and higher perceived social support. [ABSTRACT FROM AUTHOR]

Neurodevelopmental disorders (NDD) are a group of conditions that typically manifest early during the child's development with lifelong consequences. Early identification using efficient screening tools can positively modify the natural history of the disorder. ESSENCE Q is a simple questionnaire to detect ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations to reflect the co-existence of NDDs in children less than five years). There are limited studies on the validity of ESSENCE Q in detecting NDDs in young children in India. We did a cross-sectional study in a tertiary care hospital to evaluate the validity of ESSENCE Q in detecting neurodevelopmental disorders. We translated the ESSENCE Q and subsequently used it to screen for NDD in 100 children aged 12–60 months. Clinical consensus diagnosis by two experienced experts was taken as the gold standard. 23% were diagnosed as having NDD as per the clinical consensus diagnosis. Around half the children (46%) were "at-risk for NDD" based on the ESSENCE Q scale. We found an optimal cut-off for ESSENCE Q of more than or equal to 4 with a sensitivity of 96%, a specificity of 82%, and a Youden index of 0.77. ESSENCE Q has good predictive validity to be used as a quick and easy screening tool to detect NDDs in young children under the age of 5 years • 23% of the pre-school aged children had neurodevelopmental disorder (NDD) based on consensus clinical diagnosis using the DC 0–5. • Around half (43.5%) of the children had multiple NDDs suggesting high rates of comorbidity. • A cut-off score of ≥ 4 on ESSENCE Q screening tool showed a sensitivity of 0.96, a specificity of 0.82, and a Youden index of 0.77. • Parental responses on ESSENCE Q can be used as a brief screening tool to detect NDD in early childhood. [ABSTRACT FROM AUTHOR]

There is a paucity of research on interventions targeting preschool children with autism spectrum disorders (ASD) for school readiness. The objectives of this study are to develop and validate a school readiness module for making children with ASD ready for inclusive education and a scale to assess school readiness in them. Based on literature review, principles of learning, and techniques of behavioral intervention, a module was developed and reviewed by independent experts regarding the utility of the contents. A scale to assess school readiness was also developed to measure the impact of administering the module on children with ASD which was also validated by the same set of experts. Lawshe's content validity ratio was used to assess the appropriateness of each item for inclusion in the module and scale. Experts (n = 6) gave their opinion on the usefulness of the School Readiness module for children with ASD. The experts agreed that most of the content under each component were valid with the exception of identification of objects by function, identification of environmental sounds and answering social questions. Similarly, in the school readiness scale there was good agreement for all items except for 1 item under domain 2 and 2 items under domain 5. A school readiness module and a scale to assess school readiness based on interventions provided as per the school readiness module were developed and validated. Further studies are needed to assess the utility of the module and scale in children with ASD. • Inclusive education for children with autism spectrum disorder is an unrealized dream for many parents. • An attempt has been made to develop a module for parent mediated training of children with ASD to make them for inclusive education. • A scale has also been developed and validated to assess the school readiness in children with ASD. [ABSTRACT FROM AUTHOR]

Low vitamin D levels have been implicated in postpartum depressive disorders. However, studies on bioavailable vitamin D levels in postpartum depression are limited. Our study aimed to assess the serum concentrations of total, free and bioavailable 25-hydroxyvitamin D (25(OH)D) levels in women with postpartum depressive symptoms (PPD) and the association between 25(OH)D levels and PPD at 6 week post-delivery. In this cross-sectional study, a total of 330 cases and 330 age and BMI matched controls were recruited from the tertiary care hospital in South India. Women with depressive symptoms were assessed using the validated Edinburg Postnatal Depression Scale (EPDS) and cut-off score ≥10 was used. Serum 25(OH)D and VDBP levels were measured using commercially available ELISA kits. Serum total, free and bioavailable 25(OH)D levels were significantly lower in postpartum depressive women compared to non-depressive women (p <0.001, p = 0.01). A significant negative correlation was observed between 25(OH)D, free 25(OH)D and bioavailable 25(OH)D with EPDS score in total study subjects (p <0.001, r = −0.19; p <0.001, r = −0.14 and p <0.001, r = −0.14). Multivariate linear regression analysis further confirmed a significant association between serum total, free and bioavailable 25(OH)D levels and EPDS score (p <0.001∗). Our study demonstrated that lower serum total, free and bioavailable 25(OH)D levels were associated with postpartum depressive symptoms. Hypovitaminosis D after delivery may be a risk factor for postpartum depression. [ABSTRACT FROM AUTHOR]

Mobile phone short messaging service (SMS) reminders may be a low-cost method for promoting medication adherence. Our objective was to determine whether text SMS reminders improve medication adherence in patients with bipolar I disorder even after discontinuation of the intervention. Participants were stable adult bipolar I disorder outpatients on maintenance medication who were randomized to receive treatment as usual (TAU; n = 70) or TAU plus twice-weekly medication reminders by SMS (n = 62) for 3 months. Rater-blinded assessments of medication adherence, treatment attitudes, and quality of life (QoL) were obtained at baseline, at the 3-month intervention endpoint, and at a 3-month post-intervention follow up during which both groups received TAU. Intent-to-treat analyses were conducted on the full randomized sample. The clinical trial protocol was registered with the Clinical Trials Registry of India (CTRI) (CTRI/2016/07/007101). The SMS intervention improved medication adherence and attitudes towards medication at the end of the treatment phase; these benefits were maintained for medication adherence but not for attitudes towards medication at the end of the follow-up phase. The SMS intervention did not improve QoL outcomes. These findings indicate that biweekly SMS reminders improve medication adherence and the benefits persist for at least 3 months after the SMS reminders are discontinued. The SMS reminders do not affect attitudes towards treatment or QoL. [ABSTRACT FROM AUTHOR]