Medicine and Health Sciences Commons^™

Socio Cultural Risk Factors And Suicide Prevention, Amresh Srivastava

Amresh Srivastava

Society at large, particularly in the developing countries has been undergoing rapid socio-economic changes. There are newer risk factors for mental disorders playing a crucial role in pathogenesis e.g. economic transition and social inequalities. Students suicide and farmers’s have been of particular concern.Newer challenges need befitting responses, which are seldom sufficiently available in any society. Most conspicuous barrier to identify and treat mental disorders is human resources, which is not only dismal but also unequally distributed amongst different geographical and social strata of society. Globalization has changed the agenda for mental health. It’s now demonstrated that people immigrate, they share …

Risk, Vulnerability And Resilience: An Epigenetic Trajectory Of Psychiatric Disorders, Amresh Srivastava

Amresh Srivastava

Biopsychosocial model is generally widely accepted for pathogenesis of mental disorder, recent research shows a different concept. . Social, cultural, environmental factors possibly interact in a complex way to give rise to behavioral symptoms in a particular disorder. Such factors are considered 'risk factors'. but their discrete role in causation of illness is less clear. Two main factors appear to play important role which may partially explain this process. 1. risk-vulnerability and stress diathesis model and the 2. Gene-environment interaction. Both may be operating simultaneously. Our understanding of psychosocial risk factors has been changing in recent years. Psychosocial risk can …

Risk, Vulnerability And Resilience: An Epigenetic Trajectory Of Psychiatric Disorders, Amresh Srivastava

Amresh Srivastava

ABSTRACT: Risk, Vulnerability and Resilience: An epigenetic trajectory of psychiatric disorders Amresh Shrivastava. Biopsychosocial model is generally widely accepted for pathogenesis of mental disorder, recent research shows a different concept. . Social, cultural, environmental factors possibly interact in a complex way to give rise to behavioral symptoms in a particular disorder. Such factors are considered 'risk factors'. but their discrete role in causation of illness is less clear. Two main factors appear to play important role which may partially explain this process. 1. risk-vulnerability and stress diathesis model and the 2. Gene-environment interaction. Both may be operating simultaneously. Our understanding …

Need For Newer Experiments In Strengthening Education And Training Human Resource Development For Suicide Prevention, Amresh Srivastava

Amresh Srivastava

Suicide is a global public health problem and one of the leading causes of premature death for all ages. Studies show that only 25% suicide has been within health care system, we have no information about the rest 75%. To bring more people at risk for suicide is an urgent requirement which makes a strong argument education and awareness.The WHO acknowledged that suicide prevention requires intervention from outside the health sector and calls for an innovative, comprehensive multi-sectorial approach, including both health and non-health sectors, e.g. education, labor, police, justice, religion, law, politics, the media. . Early identification of at-risk …

Education And Training For Human Resource Development For Suicide Prevention' In Low And Middle Income Countries, Amresh Srivastava

Amresh Srivastava

Developing countries have more than two-thirds share of suicide in the world with dismal numbers of trained professionals. WHO data shows that more than 90% suicide occurs in the mentally ill individuals. Lack of effective manpower continues to be one of the three main barriers for prevention of suicide world over, particularly in developing countries, followed only by stigma and non-availability of care. Therefore training and education, especially for people, like teachers and health workers, who are in direct contact with vulnerable groups, can help increase identification of individuals with related problems, offer support, and make a referral. Though the …

A Study Of Resilience Amongst People Who Lost Their Relatives In Natural Calamity: Uttarakhand In Northern India., Amresh Srivastava, Chetan Lokhande, Nilesh Mohite, Avinash Desouza, Nilesh Shah

Amresh Srivastava

Background

Natural disasters can be a devastating experience for anyone. Mental disorders are common amongst survivors of natural disasters. Resilience is a significant factor that helps these survivors overcome this traumatic episode. In this study, we attempt to examine whether the level of resilience differs with nature of loss, in this case a natural calamity.

However, it remains undetermined if the level of resilience has any relation with the nature of trauma.

Resilience is one attribute that helps an individual recovers from a disastrous event It is a dynamic process, enabling an individual to successfully adapt to severe adversities. It …

What Prevents Re-Hospitalization? The Patents Of Psychopathology: Patient-Centric Management Of Psychopathology, Amresh Srivastava

Amresh Srivastava

What prevents re-hospitalization? The patents or psychopathology: Patient-centric management of psychopathology

Authors: Amresh Shrivastava, Coralee Belmont, Miky Kaushal, Avinash DeSouza, and Robble Campbell

Background Re-hospitalization is one of the priority areas of research. About 30 – 50% patients are re-hospitalized within one year of discharge. Inability to identify vulnerable candidates for repeated admissions limits our options for strategic treatment. Hospitalization occurs despite best possible community care. It is likely that untreated clinical or psychopathological may be responsible for re-admission which have not been addressed. Early initiation of effective post discharge treatment, prior to discharge may offer good benefit however indicators …

Global Mental Challenges: Response To Local Needs, Amresh Srivastava

Amresh Srivastava

Global mental Challenges: Response to local needs 1Amresh Shrivastava Running Title: Mental health: beyond Geo-political Boundaries 1Department of Psychiatry, Elgin Early Intervention Program for Psychosis, The University of Western Ontario, Ontario, Canada, and Mental Health Resource Foundation, Mumbai, Maharashtra, India, e-mail: dr.amresh@gmail.com.

The health of the people determines athe health of a society and a country. Reference to ‘health’, more often than not, directs one’s thinking towards physical health, without realizing that physical health is inseparable from mental health. Physical disorders co-exist with mental disorders and mental disorders are a significant risk factor for physical illnesses. The WHO agenda on …

Burden Of Stigma On Mentally Ill And Social Exclusion, Amresh Srivastava

Amresh Srivastava

Stigma of mental illness causes great burden on the patients and their families. It leads to discrimination, social exclusion and personal isolation. It occurs across all social, economic, and cultural class and geographical regions. As one of the greatest barrier to treatment and outcome, it is a potential clinical risk which leads to suicide, violence, physical impairment, physical illnesses, unemployment, and economic deprivation. People having mental illness suffer prejudice due to stigma. Anti-stigma measure is focussed on public health. Answer to stigma lies in personalised interventions. We carried out systematic studies to understand patient and family’s perception, and proposed clinical …

Risk Level And Range Of Suicidality Amongst Non-Attempting Early Psychosis Patients., Amresh Srivastava, Megan Johnston, Charles Nelson, Robboe Campbell

Amresh Srivastava

Purpose: Patients who are not admitted with a suicide attempt also kill themselves in post discharge period. The purpose of the study was to examine suicide risk of those patients who are not admitted due to a suicide attempt. Methods: Sixty inpatients with early psychosis were assessed in a naturalistic cross-sectional, cohort study. Standard tools for measurement of psychopathology were used. Range of suicidality and its severity was studied using a locally developed suicide assessment instrument, Scale for Impact of Suicidality-Management, Assessment and Planning of Care (SIS-MAP). Results: Out of 60 patients, 32-showed severe suicidality and 28-showed low suicidality. Characteristics …

Reducing Treatment Delay For Early Intervention: Evaluation Of A Community Based Crisis Helpline, Amresh Srivastava

Amresh Srivastava

Background A limited number of studies have assessed the pathways to care of patients experiencing psychosis for the first time. Helpline/clinic programs may offer patients who are still functional but have potential for crisis an alternative that is free from judgment. Methods In this study we report on patient calling a round-the-clock crisis helpline for suicide prevention supported by psychiatric facilities in Mumbai, India. Chi-square and test of mean differences were used to compare outcomes between first-episode patients and those with a previous history. Results Within five years, the helpline received 15,169 calls. Of those callers, 2341 (15.4%) experienced suicidal …

Should ‘Risk Syndrome Of Psychosis’ Be Included In Dsm V As A Diagnosis? A Road Towards Preventive Psychiatry”, Amresh Srivastava

Amresh Srivastava

Psychiatric diagnosis has acquired a position of a quasi-legal document for mental health services and agencies working with mental health. Its utility has gone far beyond ‘clinical diagnosis for treatment’.

The concept of risk syndrome for schizophrenia has been thoroughly researched in last ten years or so. Significant advancement has been made in phenomenology, diagnostic criteria, classification, & neurobiology. The research of prodromal or at-risk or Ultra high-risk psychosis has significantly contributed to the body of knowledge of aetio-pathogenesis of schizophrenia.

The science of risk syndrome has apparently matured and its proponents are ready for its inclusion in DSM V …

Outcome, Early Intervention & Dup: The Matrix Of Research In Early Psychosis, Amresh Srivastava, Megan Johnston

Amresh Srivastava

There has been little investigation of the relationship of DUP to other long-term outcomes such as negative symptoms and cognitive functioning neither have the possible confounds of DUP been widely investigated or controlled. It is important that there should be more thorough investigations of DUP, its correlates, and the extent to which it does mediate any advantages of earlier intervention. Shorter duration of untreated psychosis was associated with greater response to antipsychotic treatment, as measured by severity of global psychopathology, positive symptoms, negative symptoms, and functional outcomes. At the time of treatment initiation, duration of initially untreated psychosis was associated …

Optimizing Outcome Measures For Schizophrenia: From Research To Clinics, Amresh Srivastava, Nina Schoolar, Alexander Miller, Jitenra Trivedi

Amresh Srivastava

Outcome measures in schizophrenia have evolved considerably to bring in more objectivity, uniformity and attempt to reflect ‘real-life’ situation. It has significantly moved away from measurement of symptom remission to assessment of level of functioning and quality of life parameters. Schizophrenia is a complex neurobehavioral disorder afflicting approximately 1% population, with onset in early adolescence, across the world. It cause immense burden of patients, families and caregivers. The economic cost of schizophrenia is enormous. It is therefore important that assessment of schizophrenia be reflective of ground reality, scientific, evidence-based and comprehensive. Several researchers have proposed multidimensional outcome parameters. The heterogeneity …

Cognitive Factors In Long Term Outcome Of First Episode Psychosis, Amresh Srivastava, Megan Johnston, Nilesh Shah, Meghana Thakar, Larry Stitt

Amresh Srivastava

Cognitive factors in long term outcome of first episode psychosis

Amresh Shrivastava, Megan Johnston, Nilesh Shah , Meghana Thakar , and Larry Stitt

a Excecutive Director , Mental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602, Currently: Assistant Professor of Psychiatry, The University of western Ontario, & associate Scientist, Lawson Health Research Institute, London, Ontario,Canada, E Mail : amresh.edu@gmail.com b Professor of Psychiatry LTMG Hospital, University of Mumbai, Sion, Mumbai, Maharashtra, India 400 022 c Clinical psychologist, Silver Mind Hospital, Mumbai,India d Department of Epidemiology & …

Neurobiological Markers Of Schizophrenia: Findings From Indian Studies Of Early Psychoses, Amresh Srivastava, Megan Johnston, John John, Harsha Halahalli, Shivarama Varambally Varambally

Amresh Srivastava

Neurobiological Markers of Schizophrenia: Findings from Indian Studies of Early Psychoses. Amresh Srivastava, Megan Johnston, John John, Harsha Halahalli,Shivarama Varambally 1The University of Western Ontario, London, Ontario, Canada/3NIMHANS, Banglore , Karnataka , India OVERALL PANEL PROPOSAL: Advancement in technology together with early intervention studies have revealed a great deal about changes in neurobiological profile of brain in schizophrenia. In last fifteen years , there has been a trend all over the world to study early psychosis from the perspective of not only risk factors and causes of psychosis but also about brain vulnerability to understand what exactly happens that emotional …

Integrating Social & Clinical Parameters In Outcome Measures Of Schizophrenia: Clinician’S Perspective., Amresh Srivastava, Nilesh Shah, Yves Bureau

Amresh Srivastava

Schizophrenia is a complex neurobehavioral disorder for which there are many promising new treatments. There is, however, a discrepancy in outcome measure reports when they are obtained from patients, relatives, caregivers, or professionals, thus making it difficult to determine the level of recovery. The reason for this lack of agreement may be due to the limitations of the measurement tools themselves, which are not comprehensive and may be measuring different aspects of outcome. Alternatively, it could be that the conceptual understanding of outcome and recovery require development. Unfortunately for one of the above reasons or both, patients assessed as “recovered” …

Effects Of Duration Of Untreated Psychosis On Long-Term Outcome Of ‘People Hospitalized With First Episode Schizophrenia”, Amresh Srivastava, Larry Stitt, Meghana Thakar, Gurusamy Chinnasamy, Nilesh Shah

Amresh Srivastava

AIM: Duration of untreated psychosis (DUP), which has emerged as a reliable predictor of outcome continues to remain under scientific scrutiny . The present study examines effect of differential periods of DUP on long-term outcome of first episode schizophrenia at Mumbai, India. Method: This is a prospective, ten year follow up naturalistic study. Hospitalized patients of first episode schizophrenia were selected and followed up Results: The mean DUP was higher for group, which showed clinical recovery on Clinical Global Impression Scale [14.0 months (SD=8.0) in recovered and 10.8 months (SD=5.7) in non-recovered group (p=0.091)]. DUP was not found to be …

Improved Schizophrenia Patient’S Ability To Work And Live Independently In The Community: A Ten-Year Long-Term Outcome Study From Mumbai, India, Amresh Srivastava, Larry Stitt, Meghana Thakar, Nilesh Shah, Gurusamy Chinnasamy

Amresh Srivastava

Background: The outcome of schizophrenia has several determinants. Socio-ecological factors, particularly living conditions, migration, community and culture, not only affect the level of risk but also the outcome. Mega cities around the world show a unique socio-ecological condition which has several challenges for mental health. The present study reports the long-term status of patients with schizophrenia in such a mega city - Mumbai, India. Aim: This study aims to reveal long-term outcome of patients suffering from schizophrenia with special reference to clinical symptoms and social functioning. Methods: The cohort for this study was drawn from a 10-year follow-up of first …

Lessons Learned From Research In Prodromal Phase Of Schizophrenia, Amresh Shrivastava, Megan Johnston

Amresh Srivastava

In the last ten years, a significant amount of research data has accumulated to identify and predict the vulnerability of individuals to develop psychosis. At a time when DSM-V academia is becoming active with field trials, researchers in prodromal psychosis research are arguing for inclusion of 'risk syndrome for psychosis,' which has generated an interesting debate. Studies indicate that approximately 80-85% of cases experience subsyndromal symptoms for a period lasting from several months to several years prior to the onset of the illness, including impaired perception, thought processes, subjective cognitive functions and mood. Also, much of the functional decline associated …

Persisting Symptoms In Recovered First Episode Schizophrenia Patients, Amresh Srivastava, Nilesh Shah, Meghana Thakar, Larry Stitt, Gurusamy Chinnasamy Chinnasamy

Amresh Srivastava

Persisting symptoms in recovered first episode schizophrenia patients

Amresh Shrivastavaa,*, Nilesh Shahb, Meghana Thakara, Larry Stittc, Gurusamy Chinnasamyd

aMental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602 bLTMG Hospital, University of Mumbai, Sion, Mumbai, Maharashtra, India 400 022 cDepartment of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada N6A 5C1 dResearch Office, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada N6A 5C1

*Corresponding author. Tel.: +1-519-631-8510; Fax: +1-519-631-2512. E-mail address: dr.amresh@gmail.com …

Assessing Risk Of Suicide In Clinical Practice: A Framework For Conceptualizing Risk., Amresh Srivastava, Charles Nelson Nelson

Amresh Srivastava

Assessing risk of suicide in clinical practice: A framework for conceptualizing risk. AmreshShrivastava MBBS, MD, DPM, MRC Psych 1 ψ Charles Nelson Ph.D., C. Psych.2 1. Assistant professor of psychiatry, Schulich School of Medicine & Dentistry, The University of Western Ontario, Regional Mental Health Care - St. Thomas, Associate scientist, Lawson health research Institute, London, Ontario, Canada, 2.Psychologist, Regional Mental Health Care - St. Thomas, Ontario, Adjunct Professor, Clinical Psychology, University of Western Ontario – London, Ontario Associate scientist, Lawson health research Institute, London, Ontario, Canada ψ. Corresponding author AmreshShrivastava MD, DPM, MRCPsych Regional mental health care, 467, Sunset Drive, …

Lessons Learned From Prodromal Research: Bringing Early Identification And Intervention In Public Health Psychiatry, Amresh Srivastava

Amresh Srivastava

Lessons learned from Prodromal research: Bringing early identification and intervention in Public Health psychiatry Amresh Shrivastava MBBS, MD, DPM, MRCPsych. a Currently: Assistant Professor of Psychiatry, The University of western Ontario, & Associate Scientist, Lawson Health Research Institute, London, Physician team Leader: Early Intervention of Psychosis Program (Elgin-PEPP) Regional mental health care.St. Thomas.Ontario,Canada Executive Director , Mental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602, E Mail : amresh.edu@gmail.com Phone: 1-5196413233 Home, 1-5196318510 Office, fax 1-5196312512 word count : Abstract: 240 Text body : 6840 References: …

Early Psychosis: A Novel Gateway For Suicide Prevention, Amresh Srivastava, Megan Johnston

Amresh Srivastava

Early psychosis: A Novel Gateway For Suicide Prevention

Amresh Shrivastava 1, Megan Johnston 2 Address: 1. Department of Psychiatry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada); Mental Health Foundation of India (PRERANA Charitable Trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602 (Present Address: Regional Mental Health Care, 467 Sunset Drive, St. Thomas, Ontario, Canada N5H 3V9; 2. Department of Psychology, University of Toronto.

Early psychosis and early intervention initiative in by now a well established model for treatment …

Duration Of Untreated Psychosis & Long-Term Outcome Of First Episode, Hospitalized Schizophrenia: Search For A Missing Link In A Linear Correlation, Amresh Srivastava, Nilesh Shah, Meghana Thakar, Larry Stitt, Gurusamy Chinnasamye

Amresh Srivastava

Duration of untreated psychosis & Long-term outcome of First episode, hospitalized schizophrenia: Search for a missing link in a linear correlation Amresh Shrivastavaa,*, Nilesh Shahb, Meghana Thakarc, Larry Stittd, Gurusamy Chinnasamye a Excecutive Director , Mental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602, Currently: Assistant Professor of Psychiatry, The University of western Ontario, & associate Scientist, Lawson Health Research Institute, London, Ontario,Canada, E Mail : amresh.edu@gmail.com b Professor of Psychiatry LTMG Hospital, University of Mumbai, Sion, Mumbai, Maharashtra, India 400 022 c Clinical psychologist, Silver …

First Episode Is The Best Episode: Lessons And Limitations In Duration Of Untreated Psychosis (Dup) And Outcome In Schizophrenia, Amresh Srivastava

Amresh Srivastava

First episode is the best episode: Lessons and limitations in duration of untreated psychosis (DUP) and outcom Amresh Shrivastavaa, *, Nilesh Shahb, Meghana Thakarc, Larry Stittd, Gurusamy Chinnasamye

a Executive Director , Mental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602, Currently: Assistant Professor of Psychiatry, The University of western Ontario, & associate Scientist, Lawson Health Research Institute, London, Ontario, Canada, E Mail : amresh.edu@gmail.com Professor of Psychiatry LTMG Hospital, University of Mumbai, Sion, Mumbai, Maharashtra, India 400 022 c Clinical psychologist, Silver Mind Hospital, Mumbai, …

Stigma And Discrimination : Mumbai Experience, Amresh Srivastava

Amresh Srivastava

Title: Stigma & Discrimination: The Mumbai Experience Main Author: Amresh Shrivastava MD, DPM, MRCPsych, University of Western Ontario, London, Ontario, Canada. Co-Authors: Gopa Sarkhel, MA, Iyer Sunita MA, Thakar Meghana MA, Shah Nilesh, MD, DPM Address of Presenter: Executive Director, Mental health foundation of India (PRERANA Charitable Trust) Mumbai, India; Currently at Department of Psychiatry, The University of Western Ontario, London, Ontario, Canada Address: Regional mental health care, 467 Sunset Drive, St. Thomas, N5N 3V9, St. Thomas, Ontario, Canada Phone: 1-5196318510; Fax: 1-519-631-2512. E-mail: amresh.edu@gmail.com Background: People with schizophrenia suffer from stigma and discrimination to a great extent, and this …

Clinical Skills In Psychiatric Assessment: An Educational Module, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Risk Assessment For Suicide Behaviour, Amresh Srivastava, Charles Nelson, Megan Johnston

Amresh Srivastava

This is an audio-visual about risk assessment of suicide behavior. Part 1. Reformulating the concept of RISK and a New instrument for assessment: Risk assessment is an important clinical responsibility, which can be ‘life-saving’. Literature on risk factors has become voluminous; however a traditional risk assessment does not take into account the most relevant factors. This reflects the prevailing conceptualization of risk, which has not been fully and completely tied to clinical outcomes. Psychopathology is currently understood in biopsychosocial terms. A more progressive conceptualization of risk should consider the interplay of both, risk and protective factors. The present work proposes …