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REVIEW ARTICLE Table of Contents   
Year : 2010  |  Volume : 52  |  Issue : 7  |  Page : 110-119
Initiatives in biological research in Indian psychiatry

Mental Health foundation of India, 209, Shivkrupa complex, Gokhale Road, Thane, Mumbai - 400 602, India

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Date of Web Publication15-Sep-2010


Biological psychiatry is an exploratory science for mental health. These biological changes provide some explicit insight into the complex area of 'brain-mind and behavior'. One major achievement of research in biological field is the finding to explain how biological factors cause changes in behavior. In India, we have a clear history of initiatives in research from a biological perspective, which goes back to 1958. In the last 61 years, this field has seen significant evolution, precision and effective utilization of contemporary technological advances. It is a matter of great pride to see that in spite of difficult times in terms of challenges of practice and services, administration, resource, funding and manpower the zest for research was very forthcoming. There was neither dedicated time nor any funding for conducting research. It came from the intellectual insight of our fore fathers in the field of mental health to gradually grow to the state of strategic education in research, training in research, international research collaborations and setting up of internationally accredited centers. During difficult economic conditions in the past, the hypothesis tested and conclusions derived have not been so important. It is more important how it was done, how it was made possible and how robust traditions were established. Almost an entire spectrum of biological research has been touched upon by Indian researchers. Some of these are electroconvulsive therapy, biological markers, neurocognition, neuroimaging, neuroendocrine, neurochemistry, electrophysiology and genetics. A lot has been published given the limited space in the Indian Journal of Psychiatry and other medical journals published in India. A large body of biological research conducted on Indian patients has also been published in International literature (which I prefer to call non-Indian journals). Newer research questions in biological psychiatry, keeping with trend of international standards are currently being investigated by the younger generation with great enthusiasm. What we have achieved so far is the foundation work in last 60 years. Our main challenge in development of biological psychiatry research in India remains resources in terms of manpower, funding and dedicated time for research psychiatrists. Developing basic sciences laboratories, discrete research questions, high quality methodology, and logistical support are some of the essentials. In the present time the culture of research has changed. It is specific and evidence-based. We have time-tested examples of International collaborative research. We need to get more resources, develop education, collaboration and effective leadership. In times to come, India will provide international leadership in basic and clinical biological psychiatry. There is hope.

Keywords: Indian, research, biological psychiatry

How to cite this article:
Shrivatava A. Initiatives in biological research in Indian psychiatry. Indian J Psychiatry 2010;52, Suppl S3:110-9

How to cite this URL:
Shrivatava A. Initiatives in biological research in Indian psychiatry. Indian J Psychiatry [serial online] 2010 [cited 2022 Sep 29];52, Suppl S3:110-9. Available from:

   Introduction Top

Biological psychiatry is an exploratory science for mental health. [1] We now understand mental illnesses from a bio-psychosocial perspective, wherein biological, psychological and social factors combine in a unique, thus far unknown, way to cause a mental disorder. [2] Traditionally it has been the understanding that biological changes in human body lead to change in behavior. These biological changes provide some explicit insight into the complex area of 'brain-mind and behavior'. [3],[4] Psychiatric research has gone through the motion 'Brainless minds' to 'Mindless brain'. We now understand more clearly the interconnection and integrated theory of several factors related to causation of mental disorders. A major achievement of research in biological field has been the findings to explain how does biological factors cause changes in behavior. [5] More recently, we also notice that biological research is involved in exploring how and what biological changes are caused by social, psychological and environmental factors, which affect mental health. Research in biological psychiatry has been a central area of research interests of Indian psychiatrists working in India as well as overseas. We have a clear history of initiatives in research from biological perspective, which goes back to 1958. In this brief review I plan to focus primarily on the studies that have attempted to find out biological causes of mental illnesses and biological changes occurring in mental illness. An important area of using psychopharmacology as a probe to understand the same question is not being covered in order to avoid duplication within this volume. This review does not discuss disease specific research and its findings in the field of biological psychiatry, which is covered in specific chapters covering several mental disorders in this volume. I will focus on development of the specialty, challenges present today and strategies to deal with them besides main researchers and their key research interest in an appendix.

   Achievements Top

In last 61 years this field has seen a significant evolution, precision and effective utilization of contemporary technological advances. [5] It is a matter of great pride to see that in spite of difficult times in terms of challenges of practice and services, administration, resource, funding and manpower the zest for research has been very forthcoming. Some of the areas of research like 'emotional stress', [6] 'cognition', [7] 'electro convulsive therapy', [8],[9] 'psychophysiology', [10],[11] and 'suicide,' [12] which were touched upon in 1950s and 60s still continue to elude researchers. Those days psychiatry was in the confines of mental hospitals, driven by treatment of severe mental disorder with very limited therapeutic tools. Research was not on the agenda. It was a passion. There was neither a dedicated time nor any funding for conducting research. It came from intellectual insight of our fore fathers in the field of mental health. It gradually grew to the state of strategic education in research, training in research, international research collaborations, settings and accreditation of centre's from the World health organization, establishment of basic science laboratories, sophisticated neuroimaging, governmental collaborations and support and many other innovative initiatives, which speaks of about 'leadership in biological psychiatry research'. This has been the single most important achievement in Indian Psychiatry.

It is not so much important what hypothesis was tested and what conclusions were derived. It is more important how it was done, how it was made possible and how traditions were established. A culture of research, much more sophisticated in contemporary medicine, was inherited by the younger generation. Biological research was conducted in mental hospitals, general hospitals, teaching hospitals, private clinics and in voluntary organizations. It continues to flourish with matching sophistication of developed world despite continuous problems of funding and lack of Governmental agenda.

   Research Interests Top

The first generation Indian psychiatrists were trained in international institutions of repute. They possessed high level of insight into cultural and social roots of India and they were able to effectively combine these components in their research curiosity. Neurochemistry, [11],[12] psychoendocrine, [13],[14] immunoglobins, [15] body fluids, [16] electroencephalography, [17] electroconvulsive therapy, [18],[19],[20],[21] neurotransmitters, [22] psychobiology, [23],[24] cerebrospinal fluids, [25] neuropsychtric models and signs,[26],[27] epilepsy, [28],[29] neuro imaging, [30],[31] plasma cortisole, [32] dexamethosone suppression test, [33],[34] lithium, [35],[36] serum chemistry, [37],[38] metabolic effects, [39] teratogenicity, [40] cognition, [41],[42] cannabis, [43],[44] dermatographics, [45],[46],[47] experimental animal studies, [48] psychophysiology, [49] biological markers, [50] thyroid, [51] heritability and genetics, [52],[53] cerebral dominance, [54] and yogic sciences [55] have been some of the major research interests of Indian psychiatrists across severe as well as common mental disorders published in the Indian journal of psychiatry. Some of these studies have achieved high citation in literature and some others still remain the key resource for new research. Interdisciplinary and inter-institutional collaborative research in neurosciences is a phenomenon of the past 15 years. All other work has been done by developing local resources, which speaks of an excellent stride and commitment for biological science.

What Indian psychiatry has witnessed in N.S. Vahia, V.N. Bagadia, A. Venkoba Rao, B.B. Sethi, S.M Channabavavanna and others, in terms of furthering Biological psychiatry, speaks of their exceptional leadership in difficult times. We hope that younger scientists will realize that it is not merely important to have a research initiative and peruse that, it is also important in the Indian context to create a conducive environment, resource, education and training for the generation next. [56] Psychiatrists from India working abroad have investigated almost similar research questions. A list of some of these is given in appendix.

   Publications Top

A lot has been published given the limited space in the Indian Journal of Psychiatry and other medical journals published in India. A large body of biological research conducted on Indian patients has also been published in International literature (which I prefer to call non-Indian journals). A substantial contribution has been made by Indian psychiatrists trained in India and working overseas. We are extremely proud of these excellent biological research inquiries explored by our own scholars at the international level. A number of them have acquired positions of distinction and acclaim in research. They are second to none and continue to provide vibrant leadership in International biological psychiatry research. A lot of work done in the field of biological psychiatry unfortunately has not been published. It remains confined to abstract books of annual and zonal conferences. A number of dissertations done during postgraduate education in psychiatry have remained unpublished. This is one area, not only in biological but psychiatric research in general, which needs significant improvement. [57] Training for writing skills and publication needs to become part of the mainstream psychiatric education. [58]

Key word and names of principal authors of biological psychiatric research published in Indian Journal of Psychiatry are Appendixes here for the purpose of readers and researchers benefit [Table 1].
Table 1: Indian author-publications in different fields of biological psychiatry in Indian journal of Psychiatry.
(some of the volumes are unavailable, thus omission is regretted; any factual error is also regretted as it is purely coincidental omission)

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Significant events in growth and development of biological psychiatry research

  1. Establishment of phychophysiological and clinical psychopharmacology department at the K.E.M Hospital, Mumbai.
  2. Establishment of the National Institute of Mental Health and Neurosciences, Bangalore and several departments in clinical and experimental studies in Neurochemistry, Genetics and Neuroimaging.
  3. Establishment of WHO collaborative center at the K.Gs medical college, Lucknow.
  4. Establishment of WHO collaborative center at the K.E.M Hospital Mumbai.
  5. Biological psychiatry unit at the Madras Medical College, Chennai.
  6. Neurochemistry unit at CMC Vellore.
  7. Department of Electroencephalographic studies at the Central Institute, Ranchi.
  8. Indian psychiatric Society's institution of an 'oration award' for excellence in Biological Psychiatry Research in India for psychiatrists under 40 years called 'Tilak venkoba Rao Oration'.
  9. ICMR Center of Research in Geriatric Psychiatry at Madurai.
  10. ICMR, Ministry of Health, Government of India research initiatives in advanced neurosciences.
  11. Department of Science and Technology's initiative of research in neurosciences.
  12. Establishment of four 'centers of excellence' in research and treatment of addiction psychiatry.
  13. Department of addiction psychiatry at the All India Institute of Medical Sciences, New Delhi.
  14. Publication of first Handbook of biological psychiatry.
  15. International Biological psychiatry workshop at Bangalore.
  16. Research training in Biological psychiatry at several centers in India.
  17. WHO-ICMR Training workshop in Biological psychiatry and psychopharmacology for south East Asian countries at KG' Medical College, Lucknow.
  18. Publication of Handbook of Biological Psychiatry Research from NIMHANS, Bangalore.
  19. Indian Psychiatric Society's initiative of establishing 'specialty Section on Biological psychiatry'.
  20. A number of workshops and training courses organized by the Indian Psychiatric Society.
  21. World Psychiatric Association's Section meeting of Biological psychiatry: 'International Convention of Biological psychiatry' Mumbai, 1996.
  22. Inaugural symposium of the new section of the World Psychiatric Association's section on Psychoneuroendocrinology, during Annual national Conference of the Indian psychiatric Society, Jaipur.
  23. Indo-US initiative for research and education in Genetics.
Current research questions in Biological Psychiatry in India

There are two contemporary theories of mental illness. According to one theory, these disorders are biological in origin and their origin, management, course, outcome and preventive strategies are almost across cultures, regions and economic class. [59] The second theory claims that these disorders only have a biological dimension. [60] The biological factors in their own right are neither enough do they determine origin, course, management, outcome and prevention. [61] Heritability in itself does not cause diseases and socio-economic conditions do not necessarily manifest as psychiatric disorders. [62],[63] Though there is consensus for the 'bio-psychosocial' model for psychiatric disorders, the pathways for manifestation of symptom, diagnostic criteria, outcome measures and prevention of mental disorders based upon this model are poorly understood. [64] It has been repeatedly demonstrated that psychiatric disorders are culturally influenced and some times culture-specific. [65]

The high quality research arising from human genomics to explain the complexity of gene-environment interaction in expression of symptoms and their response to treatment has not given specific findings as yet. [66] The field of pharmacogenetics and microbiology in mental health is also in its infancy. Indian culture, societal structure, social variability, regional heterogeneity and economic disparities are more than obvious. Biological research needs to target how social conditions influence mental illnesses. A lot of work is needed in the field of ethno-psychopharmacology and pharmacogenetics to understand efficacy and side effects of psychotropics used. Another important area to explore is the complexity of brain-mind and behavior from neurobiological perspectives. [67] Several unfortunate conditions like trauma, natural disaster, violence and abuse continue to influence manifestation and outcome of psychiatric disorders. Little attention has been paid to this important area from biological point of view. [68],[69],[70] Impact of stress on medical disorders, exploring dimensions of gene-environment interaction, biological probes for changing behavior patterns are some of the priorities. [71] Finally, nothing is more important than prevention of metal illnesses. So far this area has remained within the confines of clinical public health presuming that biological psychiatry has little to offer in terms of prevention, which is not the fact. The current research on ultra high-risk individuals, prodormal phase and early psychosis has demonstrated that early intervention from biological therapies can be successful for prevention. [72] At the minimum, it is useful in limiting the severity and disability of psychosis. Similarly, we need to urgently understand biological markers of diagnostic groups, and response to treatment across all mental disorders. A biological basis of risk and protective factors is a significant question in suicidology research. Neurobiology of brain development and factors interfering with it in the pathway of brain maturation are part of another area of priority. 'Changing behavior' may have a biological answer to what would be helpful to adjunct cultural, social, psychological, spiritual and religious 'therapies'.

Challenges and strategies

What we have achieved so far is the foundation work in last 61 years. Our leaders have done enough in preparing the runway and it's now time to take off for the younger generation. It was voiced from our organization's platform more than a decade back that reframe 'capabilities we have and resources we need'. [73]

Our main challenge for development of biological psychiatry research in India continues to be resources in terms of manpower, funding and dedicated time for research psychiatrists. Developing basic sciences laboratories, discrete research questions, high quality methodology, and logistical support are some of the essentials. In the present time the culture of research has changed. It is specific and evidence-based. There in no space for vague questions. Our post-graduation courses are required to have clear deliverables and doable objectives for education in research. Courses like advanced training, fellowship schemes, training in research methodology, statistics, designs, grantmanship, critical appraisal, writing skills and art of publications are some of the fields which need urgent attention. The initiative needs to come from universities, teaching institutions, research institutes, local governments and professional bodies.

The Indian Psychiatric Society in particular needs to do more to become role model for other institutions. There has to be some mechanism within this organization and funding bodies. A good example is the research initiative from the World Psychiatric Association, which has developed effective liaison with few reputed universities for research grants and education in research. This model is effective. We are growing in economic terms. I personally think it is possible that small steps will go long way. An annual grant of even Rs 10,000 from the IPS will be encouraging. We need to develop a culture of grantmanship in our students. Research in Biological area is not possible without large amount of money. Non-governmental bodies are available at national and international level for this purpose. Another key strategy is to develop skills in national and international collaboration in interdisciplinary research. We need to understand that education, research and clinical services are inter-related. A rich, honest and respectful environment will attract a lot of psychiatrists who lack opportunities. Networking with in the city and country is necessary. A divide between institutional and non-institutional psychiatrist is not helpful. We need an integrated approach, which is inclusive, and reflective of our population e.g. the first episode studies being performed in tertiary psychiatric institutions are less helpful. We loose the clinical population by our lack of initiative.The next strategy is to do research on a broader canvas and sustain it over the required period of time. Cross-sectional research is less qualitative than prospective longitudinal ones. Therefore, to sustain the research interest is extremely important the cost of such work needs to be built-in to the project. Quite a few inquiries die beyond pilot studies because of one reason or the other and most commonly it is the transfer of posting in service conditions. Developing strong teamwork will certainly be helpful. Last but not the least is need for focus for researchers. It is the specificity which will provide them their niche, recognition and rewards, re-enforcing future work. Popularizing and marketing your research effectively is another academic exercise. Its part of several universities' agenda for continued professional development program. We need to believe in it and bring it into practice.

International collaborations in biological Psychiatry

In times of globalization, world has become all-inclusive. Research from India has gained significantly. In practical terms, we need to enhance our quality and reputation at the international level in the field of biological psychiatry. Work, which has been done, will be popular with citation rate. Until now only a select group of researchers are well cited [Table 2] and this needs to change. International collaborations are very effective. Just to mention some work done in India with international collaborations, e.g. by Dilip Jeste on Tardive dyskinesia, [74] Neuroimaging by M.S. Keshavan. [75] Microbiology by Sahebrao Mahadik, [76] and Genetics by V.S. Nimgaokar [77] and several others in the field are successful examples. We need to catch up in this field. Psychiatric education needs to provide autonomy of thinking, practice and innovation. [78]
Table 2: Some of the significant research interests of Indian investigators published in International journals

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   Conclusion Top

Biological Psychiatry research in India has grown to some degree. Indian conditions had not been conductive to this research but the commitment and leadership in psychiatric research is commendable. Very interesting and locally pertinent research questions have been addressed in the 60 years. A lot has been published in Indian Journal of Psychiatry and in International journals of high impact. However, we are much away from where we need to be. We need to get resources, develop education in biological research, and develop effective leadership and collaboration. We need to remind ourselves of our responsibilities, be mindful of central focus in research questions and use international culture and techniques effectively. We need to address some of the culturally relevant questions. It is possible, it is doable and it must be done. Most of what I have written sounds 'political' but that is how it is at this point of time.

N.B: Any omission of facts on Indian research in Biological Psychiatry in this review is purely 'unawareness' which is inadvertently committed and regretted.

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Correspondence Address:
Amresh Shrivatava
The university of Western Ontario, London, Ontario, N5H 3V9, Canada

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DOI: 10.4103/0019-5545.69222

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