Medicine and Health Sciences Commons^™

Identifying Barriers To Mental Health Services Utilization For Black Youth In The United States: A Qualitative Study, Emily Stein, Matthew Hutnyan, Neely Myers

SMU Journal of Undergraduate Research

Mental health in Black communities and racial/ethnic disparities in mental health service utilization remain growing concerns. Evidence suggests that psychotic disorders may be more prevalent among Black individuals than white individuals and the Black community faces barriers to care that can negatively influence outcomes. To better understand these barriers, we interviewed mental healthcare providers (n = 11) and Black young adults with first-person experience of psychosis (n = 13) about the experiences of minority young adults with mental health treatment. We analyzed interview transcripts and, consistent with constructivist grounded theory methods, identified iterative patterns across individuals about barriers to care. …

Depression Secondary To Isotretinoin – A Case Report, Rohan Karkra, Megha Sadashiv, Kishor M

Digital Journal of Clinical Medicine

Depression is one of the leading causes of morbidity in the world and significantly affects the lives of people suffering from it. The exact cause of depression has not been established and it is believed to be a complex play between various social, biological, environmental, personal factors. A relatively rare but distinct cause includes pharmacological agents.

In this case report, we describe the case of a 17-year-old girl who developed depression with psychotic symptoms on two occasions, both preceded by a history of Isotretinoin use. She was admitted and treated with anti-psychotics and psychotherapy with significant improvement in her mental …

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …

Hallermann-Streiff Syndrome And Psychosis: A Case Report, Tarvis Peacock, Ubaid Khokhar, Jaclyn Murphy, Zach Murphy

HCA Healthcare Journal of Medicine

Hallermann-Streiff syndrome is a rare genetic congenital disorder, with fewer than 200 cases reported to date, that is characterized by brachycephaly with frontal bossing, micrognathia, a “bird-like” beaked nose, microphthalmia with congenital cataracts, dental abnormalities, hypotrichosis, skin atrophy, and short stature. There is limited data on psychosis in individuals with Hallermann-Streiff syndrome; the information available depicts mania rather than psychosis. This case report reviews the presentation and treatment of psychosis in a 32-year-old male with Hallermann-Streiff syndrome who was involuntarily admitted to an inpatient psychiatric unit for persecutory delusions and hallucinations. The patient’s psychosis responded well to risperidone with a …

Systematic Literature Review Of Quetiapine For The Treatment Of Psychosis In Patients With Parkinsonism, Jack J. Chen, Henry Hua, Lilian Massihi, Ivan Portillo, Azita Alipour, William Ondo, Khashayar Dashtipour

Library Articles and Research

Objective:

The purpose of this article was to determine the efficacy and tolerability of quetiapine compared with placebo or other interventions for psychosis in parkinsonism.

Methods:

Participants with a diagnosis of parkinsonism participated in randomized controlled trials (RCTs) investigating the efficacy and tolerability of quetiapine for psychotic symptoms within a defined follow-up period. The authors conducted searches on PubMed, Cochrane Controlled Register of Trials, and EMBASE for articles published from January 1991 to October 2017. Study methodology and patient- and treatment-level data were independently extracted and summarized by using descriptive statistics. Studies underwent quality assessment for risk of bias.

Results: …

Cannabis And Psychosis Through The Lens Of Dsm-5, Nathan T. Pearson, James H. Berry

Faculty & Staff Scholarship

Evidence for an association between cannabis and psychosis has been documented in literature in many forms including experimental studies, epidemiological data, and case series. The association has implications for psychotic outcomes ranging from mild to severe and occurring over minutes to years. Due to the huge variety of exposures and outcome measures reported, creating a coherent account of all the available information is difficult. A useful way to conceptualize these wide-ranging results is to consider the association between cannabis and psychosis as it occurs within the context of widely used DSM-5 diagnoses. In the present review we examine cannabis/psychosis associations …

Inviting Hallucinatory Percepts During Speech-Listening To Detect Cognitive Changes In Early Psychosis, Ana-Bianca Popa

Electronic Thesis and Dissertation Repository

Treatment outcomes for people with schizophrenia are more favourable if treatment starts early in the course of the disorder. Current detection methods lack specificity and do not make use of cognitive markers. We presented individuals experiencing a first episode of psychosis (FEP) and matched control participants with acoustically degraded meaningful and matched nonsense sentences to examine the degree to which people reported words that were not actually presented. Intrusion errors were counted when reported words were unrelated to words in the original sentence. Intelligibility (measured as words reported correctly) did not differ between groups but intrusion errors were more frequent …

Exploratory Study Of The Use Of Community Treatment Orders With Clients Of An Ontario Act Team, Magnus Mfoafo-M'Carthy, Cara Grosset, Carol Stalker, Irene Dullaart, Linda Mccoll Dr.

Lyle S. Hallman Social Work Faculty Publications

Community Treatment Orders (CTOs) have raised questions about coercion, lack of autonomy, and effectiveness in reducing hospitalizations and improving service users’ quality of life. This study examined the experiences of clients and clinicians when CTOs are used in combination with Assertive Community Treatment (ACT) in a recovery oriented approach. Eleven clients who were or had previously been on a CTO and eight ACT clinicians were interviewed. Although most clients had negative feelings about CTOs, some acknowledged their lives had improved. Clinicians reported that the decision to employ a CTO is sometimes debated within the team but they agreed that combining …

Continue, Adjust, Or Stop Antipsychotic Medication: Developing And User Testing An Encounter Decision Aid For People With First-Episode And Long-Term Psychosis, Yaara Zisman-Ilani, David Shern, Patricia Deegan, Julie Kreyenbuhl, Lisa Dixon, Robert Drake, William Torrey, Manish Mishra, Ksenia Gorbenko, Glyn Elwyn

Dartmouth Scholarship

Background:

People with psychosis struggle with decisions about their use of antipsychotics. They often want to reduce the dose or stop, while facing uncertainty regarding the effects these decisions will have on their treatment and recovery. They may also fear raising this issue with clinicians. The purpose of this study was to develop and test a shared decision making (SDM) tool to support patients and clinicians in making decisions about antipsychotics.

Methods:

A diverse editorial research team developed an Encounter Decision Aid (EDA) for patients and clinicians to use as part of the psychiatric consultation. The EDA was tested using …

Exploring A Multifactorial, Clinical Model Of Thought Disorder : Application Of A Dimensional, Transdiagnostic Approach., Mara Ann Hart

Electronic Theses and Dissertations

Background: Bleuler saw thought disorder as the core defining feature of psychotic phenomena, reflective of the “splitting of the psychic functions” that occurred when, in the process of thinking, one’s ideas and feelings disconnect, becoming fragmented and competing functions. Unfortunately, interest in thought disorder as the conceptual core of psychosis was lost with rise of the modern DSM system, paralleling the shift towards a more simplistic, categorical way of defining psychiatric disorders. Aims: This study examined thought disorder from a dimensional perspective, with the aim of disentangling qualitative heterogeneity and diverse sources of influence. Analyses were based on …

Auditory Erp Differences Across A Continuum Of Psychotic Symptoms In Non-Clinical Population, Anaya Rehman

Theses and Dissertations (Comprehensive)

Psychosis is a term given to a mental state described as a loss of contact with the real world. The aim of this thesis was to examine early non-specific psychotic experiences in a healthy population by means of two self-report screening tools: Prime Screen and Youth Psychosis At-Risk Questionnaire-Brief, and place individuals on a psychosis continuum. Across this psychosis continuum, three event related potential (ERP) components were assessed: P300, Mismatch Negativity and N100. There is evidence that P300 and mismatch negativity amplitudes diminish in individuals with psychosis. Similarly, impaired N100 amplitude suppression (increased N100 amplitudes) during vocalization has been observed …

Understanding The Employment Barriers And Support Needs Of People Living With Psychosis, Margaret Hampson, Richard Hicks, Bruce Watt

The Qualitative Report

This study investigated the employment barriers and support needs of people living with psychosis. A purposive community sample of 137 volunteers drawn from six key stakeholder groups were invited to participate in focus groups and semi-structured individual interviews to elicit their perceptions on the employment barriers and support needs of people living with psychosis. The stakeholder groups included in this study were people with lived experience of schizophrenia or bipolar disorder, carers, health professionals, employers, employment service providers, and community members. Data obtained from 14 focus groups and 31 semi-structured individual interviews were transcribed, imported into NVivo 10, and coded …

Catatonia In An Adolescent With Velo-Cardio-Facial Syndrome, Gianni Faedda, Lee Wachtel, Anne Marie Higgins, Robert Shprintzen

Robert J. Shprintzen

Velo-cardio-facial syndrome (VCFS) is the most common microdeletion syndrome in humans and is probably the most frequent genetic cause of psychosis currently known. Many psychiatric disorders have been reported to occur in people with VCFS including, but not limited to schizophrenia, unipolar and bipolar mood disorders (with or without psychotic features), schizoaffective disorder, psychosis NOS, social phobia, generalized and separation anxiety, obsessive-compulsive disorder, autism spectrum disorder, cognitive impairment, and ADHD. This report describes the psychiatric onset and development of catatonia in an adolescent female with VCFS that was undiagnosed until 15 years of age. Catatonia may be a relatively common …

Behavioural Charactertics Of Patients Vulnerable For Repeated Hospitalisation, Amresh Srivastava, Coralee Berlmont, Miky Kaushal, Avinash Desouza, Robbie Campbell, Larry Stitt

Amresh Srivastava

Background

Re-hospitalization which takes place in about 30 to 50% postdischarge patienst, leads to poor outcome, increased rate of mortality and consumes more than 2/3 of budgetary allocations. Inability to identify vulnerable candidates for repeated admissions limits our options for strategic treatment.

Methods

In this prospective study conducted at Regional Mental Health Care ( Presently Parkwood Institute) 101 patienst ( 51 feamles, mean age 43 years), were examined using standard psychometric tools on parameters of clinical, psychopathological, suicide behaviour and resiliency for their risk and preventive characerstics.

Results

We assessed 101 subjects (51 females) with mean age of 42 years. …

Severe Mental Illnesses: Training And Education, Amresh Srivastava

Psychiatry Publications

Amresh Srivastava

MD,MRCPsych,FRCPC

Associate Professore of Psychiatry

Western University

London.ON

Severe Mental Illnesses: Training and Education

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About 4% patients in the community suffer from severe mental illness and about 16% from ‘any mental disorder’

Maximum financial and human resource allocations for mental health is consumed in managing severe mental disorders, leaving very little for treatment of early phase of illness and for developing preventive program.

All of us, psychiatrists, family physicians, other mental health professionals like, nurse, psychologists, socal workers, occupational therapists, counsellors, and members of advocacy groups and mental health organisations, face the challenge for managing patients who …

Does The Addition Of Piracetam Safely And Effectively Improve Behavioral And Or Cognitive Functions In Schizophrenia?, Dieu Linh Nguyen

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine (EBM) review is to determine whether or not the addition of piracetam safely and effectively improve behavioral and or cognitive functions in schizophrenia.

STUDY DESIGN: The selected review from all English language, primary literature sources that were published between 1979 and 1999.

DATA SOURCES: Three double blind randomized controlled trials (RCT) and one case controlled clinical study that compared piracetam to a visually matched placebo was selected and found using Medline, PubMed, Ebscohost, and Cochrane databases.

OUTCOMES MEASURED: Each of the trials assessed the effect of Piracetam on behavioral and …

Beyond Easy Answers: Facing The Entanglements Of Violence And Psychosis, Nev Jones, Mona Shattell Phd, Rn, Faan

Mona Shattell

No abstract provided.

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 …

Dsm V: Hope Or Hype?, Amresh Srivastava

Amresh Srivastava

DSM V: HOPE OR HYPE?

Amresh Shrivastava,

MD,MPM,MRCPsych,FRCPC

Associate professor of Psychiatry

Western University

London, Ontario

Since more than 50 years psychiatric diagnostic is being developed by a number of organisations. As research has advanced in understanding mental illnesses,need for a common language has been felt in order to provide best possible care to our patients.

The process of psychiatric diagnosis has evolved significantly. WHO as well APA both have made significant advances in developing diagnostic systems. DSM 5 recently approved by board of trustees by Americal psychiatric Association is scheduled to be released on 18th of May. This document …

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 …

Early Intervention Of Psychosis And Re! Ections For Programmes In India, Amresh Srivastava

Amresh Srivastava

Mental illness is perhaps the most common and most debilitating among non-communicable diseases. Schizophrenia, for example, normally occurs before the age of 25, affect the most productive years of life. The World Economic Forum graphically illustrates that mental illnesses will be a major contributor to the erosion of gross domestic product over the next 20 years. The developed world has established programs that have proven to be clinically and economically effective and sustainable.[1] Early intervention has played an important role in demonstrating that outcome can be improved if patients are treated in the early phase of illness. It is believed …

Suicide From A Global Perspective, Amresh Srivastava

Amresh Srivastava

This book is in 5 volumes, Hard cover and e-book, with 110 Chapters and contributions from more than 30 Countries

Amresh Shrivastava (ed), Megan Kimbrell and David Lester Handbook of Suicide From Global Perspective

Preface by Professor N. Sartorius, MD, PhD

Suicide is the cause of death for nearly one million people a year. Death by suicide is often reported as being due to other causes to avoid stigmatization and other negative consequences of suicide for the family: it can therefore be assumed that the number of people who commit suicide is much higher than this number. Attempts of suicide …

“Attenuated Psychotic Symptoms Syndrome” As A Risk Syndrome Of Psychosis, Diagnosis In Dsm-V: The Debate, Amresh Shrivastava, P. D. Mcgorry, Ming Tsuang, Scott W. Woods, Barbara A. Cornblatt, Cheryl Corcoran, William Carpenter

Amresh Srivastava

Schizophrenia is a common disorder, affecting approximately 1 out of every 100 people, with a typical onset during adolescence and early adulthood. The personal and societal costs of schizophrenia are extremely high. Prevention of schizophrenia, would offer substantial benefits to patients, their family members, and the community at large. The prodromal phase of schizophrenia has been recognized since the 19th century. At-risk individuals for psychosis and schizophrenia are the subjects who can provide information for intervention prior to development of frank psychosis. This approach is currently being investigated. The question remains, however, whether it can be a diagnostic category by …

Should “Risk Syndrome For Psychosis” Be Included As A Diagnosis In Dsm-V?, Amresh Shrivastava

Amresh Srivastava

No abstract provided.

Psychoendocrinology (Thyroid Hormone) And Early Psychosis: Preliminary Findings, Amresh Srivastava, Megan Johnston, Lenore Purde, Robbie Campbell

Psychiatry Presentations

No abstract provided.

Serum Lipids And Suicidality In Early Psychosis: Is There A Connection? A Preliminary Study, Amresh Srivastava, Megan Johnston, Lenore Purde, Robbie Campbell

Psychiatry Presentations

No abstract provided.

Serum Lipids And Suicidality In Early Psychosis: Is There A Connection? A Preliminary Study, Amresh Srivastava, Megan Johnston, Lenore Purde, Robbie Campbell

Amresh Srivastava

No abstract provided.

Psychoendocrinology (Thyroid Hormone) And Early Psychosis: Preliminary Findings, Amresh Srivastava, Megan Johnston, Lenore Purde, Robbie Campbell

Amresh Srivastava

No abstract provided.

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

Psychiatry Presentations

No abstract provided.

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

Amresh Srivastava

Duration of untreated psychosis (DUP) has emerged as a reliable predictor of outcome but continues to remain under scientific scrutiny. The present study examines the effect of differential periods of DUP on long-term outcome of first episode schizophrenia at Mumbai, India. This research was a prospective, 10-year follow-up naturalistic study. Hospitalized patients of first episode schizophrenia were selected and followed up. Results showed that the mean DUP was higher for a 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 …