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Platelet to lymphocyte ratio and monocyte to lymphocyte ratio in depression: a case-control study Taniya, Aditya Somani, Rakesh Kumar Gupta, Ajay Kuma AIIMS, Raipur E-mail- [email protected] Introduction: Platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) are cheap and readily available blood parameters that are markers of inflammation and bear the potential to serve as biomarkers for depression. Aims: The primary objective of this study was to compare PLR and MLR in patients of unipolar depression with healthy controls. The secondary objectives of this study were to analyze the correlation of PLR and MLR with the severity of depression at baseline and to assess the change in PLR and MLR in patients with depression after treatment. Subjects and methods: Consenting drug-free patients of unipolar depression were included as cases if they were aged >18 years, any gender, and were free of other psychiatric disorders, substance dependence except caffeine/nicotine, major medical/hematological illness/infection, pregnancy, or lactation. Age and sex-matched healthy adults were recruited as controls with consent. All the participants were assessed at baseline, and cases were reassessed after at least six weeks of treatment. Results: The PLR was significantly higher (p-value = 0.002) among the cases (median: 124.51, IQR:63.17) than the controls (median: 99.50, IQR:47.85), at baseline, before starting treatment. The area under curve for the receiver operating characteristic curve for PLR values at baseline was 0.633. The MLR did not differ significantly between the two groups. There was no change in PLR or MLR in cases after treatment. The PLR and MLR values did not correlate with the severity of depression at baseline. Conclusion: PLR, not MLR, could be a potential trait marker for depression. Further studies are warranted. Keywords: Depression; Inflammation; Monocyte to lymphocyte ratio; Platelet to lymphocyte ratio Default mode network activity and connectivity in first episode schizophrenia: an fMRI study Dr. Dhiman Ranjan Bharadwaj, Prof. (Dr.) Basudeb Das, Dr. Sunil Kumar Suryavanashi Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India BACKGROUND Recent studies have shown cognitive deficits in first episode schizophrenia (FES) patients. Studies show altered functional connectivity in the schizophrenia patients, but FES studies are lacking. AIM The purpose of the current study was to investigate the cognitive deficits in patients of FES and study Stroop task activated functional connectivity using BOLD sequence in fMRI. METHODOLOGY 20 consented FES patients and 10 healthy controls (HC) were recruited for the study. Cognitive functions were assessed in FES patients and HC using Montreal cognitive assessment (MoCA), and both the groups underwent fMRI to see BOLD activation patterns during a Stroop paradigm. Patients were followed up after 6 weeks of treatment with repeat scans and cognitive function assessment. RESULTS The findings show cognitive deficits in the FES patients as compared to HC. Hyperactivation of the default mode network (posterior cingulate gyrus, right thalamus, left precuneus and bilateral cuneus) in preference to the cognitive control network (DLPFC) in the patients was noted during tasks of focussed attention. CONCLUSION Our study findings provide evidence in support of cognitive dysfunction in FES, with specific neural correlates, highlighting the neurodevelopmental origin of the disease. Key words: fMRI, MoCA, first episode schizophrenia, cognitive control network, default mode network Understanding Depression Pathways: Resilience as a Moderator and Early Maladaptive Schemas as Mediators of Adverse Childhood Experiences Mahadev Singh Sen, Prerna Sharma, Nishtha Chawla; IHBAS, New Delhi Adverse Childhood Experiences(ACEs), have significant associations with various psychiatric disorders, including depression. Early Maladaptive Schemas (EMSs) develop in response to adverse experiences, mediate the impact of ACEs on psychopathology for which Psychological resilience act as a protective factor. Methods: A cross-sectional observational study was conducted among individuals primary diagnosis of diagnosed with depression and aged 18-55 were included(N=150) with purposive sampling. Psychometric instruments included the Beck Depression Inventory-II(BDI-II), ACE-IQ, Young Schema Questionnaire(YSQ-S3), and Connor-Davidson Resilience Scale(CD-RISC). Correlations and mediation/moderation analyses were performed to explore the relationships among ACEs, EMSs, resilience, and depression. Results: Most people experienced physical abuse(62%), emotional abuse(75%), exposure to violence within the family(71%), bullying(51%), and community violence(55%) as adverse experiences. Correlation analysis demonstrated a weak to moderate positive association between ACEs and EMS severity(r=0.261, p=0.001) and a strong negative association between resilience(CD Risk Score) and EMS severity(r=-0.416, p < 0.001). Depressive symptoms showed a weak positive correlation with ACEs(r=0.199, p=0.015) and a strong positive correlation with EMS(r=0.626, p < 0.001), but a strong negative correlation with resilience(r=-0.592, p < 0.001). Resilience moderated the relationship between ACEs and depression. Early Maladaptive Schemas mediated the ACEs-depression relationship. When resilience was low, the direct effect of ACEs on depression was significant(b=0.789, p=0.014), while at higher resilience levels, the impact of ACEs diminished. Conclusion: The clinical significance of resilience-building interventions for individuals with a history of ACEs, offering potential avenues for tailored therapeutic strategies. Understanding these dynamics and phenomenological pathways to depression informs holistic approaches for prevention and treatment. Keywords: Childhood trauma, childhood adversity, early maladaptive schemas, resilience, depression. The Impact and Outcome Evaluation of Tele-mentoring for Practicing Medical Officers in Prison and Correctional Settings of Bihar in Primary Care Psychiatry B. Sai Chaitanya Reddy, P. Laxmi Nirisha, Shivanee Kumari, Narayana Manjunatha, Channaveerachari Naveen Kumar, Suresh Bada Math NIMHANS, Bengaluru Background: As compared to the general population, studies consistently reported jail inmates have a high prevalence of mental illness and substance use disorders. To meet this need, a digitally driven, 1-year Primary Care Psychiatry Program (PCPP) was designed for the medical officers in prison and correctional settings deputed by the Government of Bihar. Aim: The study aimed to assess the impact of digitally driven 1-year PCPP on the prison medical officers Materials and Method: Out of seven, only five Medical officers completed training. Training contained brief onsite training in “Clinical Schedule for Primary Care Psychiatry” and 3 online modules containing Tele-Psychiatric On- Consultation Training, Virtual Classroom Sessions and Public Health module. Translational Quotient (TQ) and Primary Care Psychiatry Quotient (PCPQ) were utilized to measure the outcome. Results: The TQ scores in the 1st and 2nd Tele-OCT evaluations were 64% and 75.2%, at 6 and 12 months of the course respectively, suggestive of adequate skill retention. The PCPQ found to be 8.7%, i.e., 2947 psychiatric disorders were identified out of 33,565 consultations over 12 months. Conclusion: A yearlong training has demonstrated the efficacy in acquisition of primary care psychiatry skills, and these competencies were translated into care over 12 months. Effectiveness of an intervention to address COVID-19 vaccine hesitancy among pregnant women: randomized controlled trial Kumari Padma, Ramdas Ransing, Prerna Kukreti, Pracheth Raghuveeer, BKL Walawalkar Rural Medical College, Sawarde, Ratnagiri Background: Case fatality rate of COVID-19 among pregnant women during the second wave of COVID-19 - 5.7 percent (22/387) according to ICMR data. With the onset of the COVID-19 pandemic, vaccines emerged as a primary prevention tool. However, vaccine hesitancy, particularly among antenatal care (ANC) women, poses challenges to maternal, child health and achieving herd immunity. Objective: To develop and evaluate the effectiveness of Health Care Workers (HCWs) -delivered Vaccine hesitancy intervention (VHI) in reducing COVID-19 vaccine hesitancy and vaccine rejection rate among vaccine-hesitant pregnant women Methods: This study is a randomized, open-label, parallel- group, multicentric trail being conducted in 3 health care facilities across India. The result of one of the site, BKL Walawalkar Rural Medical college, Sawarde, Maharashtra is presented in the study. A total of 984 ANC women were screened.229 eligible participants were randomly allocated into two groups of individual intervention( Intervention given by nurse) and EUC. The primary outcome is to compare the proportion of women getting vaccinated across both groups. Participants are assessed using assessment tools at baseline and followed up after 8 weeks. Secondary outcomes is Conclusion: COVID-19 vaccine hesitancy among pregnant women was highly prevalent 2021.Govt of India has implemented several strategies (mostly web-based, community based , Information providing). The effective individual level interventions was not available, thus addressing the COVID-19 vaccine hesitancy was major challenge for primary health care workers.

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