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Targets Of Therapeutic Intervention For Prevention Of Repeated Hospitalization: Need For Developing ‘Personalised Care Model’, Amresh Srivastava

Amresh Srivastava

Targets of therapeutic intervention for prevention of repeated hospitalization: need for developing ‘personalised care model’

Amresh Srivastava1, Coralee Belmont 2, Miky Kaushal 3, Avinash DeSouza 4 Robbie Campbell 5 and Larry Stitt 6 1. Associate Professor of Psychiatry, The Western University, Associate Scientist, and Lawson Health research Institute. Consultant psychiatrist Adult Ambulatory and Psychosis Program. Parkwood Institute Wellington Road. London. ON, N6C 0A7 2. Psychiatric Social worker southwest forensic mental health. St. Thomas 3. Research Fellow, Regional mental health St. Thomas 4. Research Fellow, LTMG Medical College and mental Health Resource Foundation, Mumbai, India 5. Emeritus Professor of Psychiatry. The …

Targets Of Therapeutic Intervention For Prevention Of Repeated Hospitalization: Need For Developing ‘Personalised Care Model’, Amresh Srivastava

Amresh Srivastava

Amresh Srivastava1, Coralee Belmont 2, Miky Kaushal 3, Avinash DeSouza 4 Robbie Campbell 5 and Larry Stitt 6 1. Associate Professor of Psychiatry, The Western University, Associate Scientist, and Lawson Health research Institute. Consultant psychiatrist Adult Ambulatory and Psychosis Program. Parkwood Institute Wellington Road. London. ON, N6C 0A7 2. Psychiatric Social worker southwest forensic mental health. St. Thomas 3. Research Fellow, Regional mental health St. Thomas 4. Research Fellow, LTMG Medical College and mental Health Resource Foundation, Mumbai, India 5. Emeritus Professor of Psychiatry. The Schulich School of medicine and dentistry. 6. Consultant, Statistical services, London. ON Canada Background Strategies …

Brain Maruration And Poverty, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Positive Psychiatry, Amresh Srivastava

Amresh Srivastava

Revolutionary advances in understanding mental disorders and in providing novel treatments have enhanced the expectations of patients and relatives. There is a growing demand on newer research in providing interventions that allow patients to live a normal life. Of late, concept of the illness itself has undergone significant change. It is now proposed that expected outcome from treatment of mental disorder is to achieve a state of ‚ ‘wellness.’ Positive psychiatry is a newer branch of psychological medicine that seeks to promote understanding of wellness and examines its application in intervention and prevention of mental disorders. The concept of positive …

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. …

Should Suicide Behaviour Be An Outcome Parameter For Mental Disorder, Amresh Srivastava

Amresh Srivastava

Suicide and mental illness are closely related to each other. A high number of people who commit suicide suffer from a mental illness, and a high number of mentally ill patients exhibit suicide behavior. Suicide behavior is a significant aspect of mental illness. It is consistently observed throughout the course of illness, seen in the prodromal stage, during acute phase of remission, in residual phase and whenever illness relapses. A number of times, mental disorder improves but suicide behavior persists. 10-15% patients attempt suicide in the initial phase of an illness. More than half of the patients get hospitalized due …

Abc Of Severe Mental Illnesses, Amresh Srivastava

Amresh Srivastava

Amresh Srivastava MD,MRCPsych,FRCPC Associate Professore of Psychiatry Western University London.ON Severe Mental Illnesses: Training and Education - 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 …

Identification Of Risk Factors For Suicide Amongst Psychiatric Patients: Can Structured Measurement Tools Be More Specific?, Amresh Shrivastava, Robbie Campbell, Megan Johnston, Coralee Berlmont, Miky Kaushal, Avinash Desousa, Larry Stitt, Charles Nelson

Amresh Srivastava

Background One of the main challenges in suicide prevention is that it cannot be predicted. Significant number of patients attempt suicide while being under psychiatric treatment. Lethality and intent of each risk factor varies and remains inconsistent. Though structured instruments have also been useful with limited success search for newer methods remains an urgent clinical need. We believe risk is multifactorial and a scale based upon fundamental domains of biological, psychological, social, environmental, spiritual and clinical origin can elucidate more specific factors. Scale for impact of suicidality- Management, Assessment & Planning of care-brief screener (SISMAP-bcs) is 23 item scale which …

The Flip-Side To Readmission: Focused After-Care, Amresh Srivastava

Amresh Srivastava

paper 1. Suicidality in hospitalized early psychosis patients at time of discharge

The purpose of this study was to investigate the presence and nature of suicidal risk among early psychosis patients at the time of discharge from hospital. Is it only related to the involvement of a suicidal attempt at admission? Thirty such patients, who were admitted after a suicide attempt were compared with 30 patients similarly diagnosed, but admitted for clinical reasons not involving a suicide attempt. Dependent measures of psychopathology, adjustment and suicidality were used. It was found that the two groups did not differ in suicidality, which …

Resilience: A Psychobiological Construct For Pathway Of Suicidality, Amresh Srivastava, Corelee Berlmont, Miky Kaushal, Avinash Desouza, Robbie Campbell, Larry Stitt

Amresh Srivastava

Absttract: Background and objective Resilience which is a neurobiological and behavioral construct may modulate psychopathological trajectory as a ‘final common pathway’ for suicide behavior. Since it allows people to adapt to adversity and bounce back to normalcy, treatments based upon modifcation of resilience may be a possibility. Objective of this prospective, cross-sectional study was to examine association of resilience and suicidality in individuals with psychiatric disorders attending Regional RMHC, St. Thomas and London. Method We measured level of resilience by using Connor-Davidson scale (CD-RISC, cut-off 60), suicidality by Scale for Impact of Suicidality Management, Assessment and Planning of Care brief …

Resilience : An Independent Psychobiological Mental Health Construct (Guest Editorial), Amresh Srivastava

Amresh Srivastava

Survival against trauma is a unique characteristic of all human beings. While a number of factors contribute in building this capacity, resilience appears to be the most important one. Interest in studying resilience arises from number of areas which are of utmost clinical significance such as such as exploring the possibility of at-risk individuals who developing a mental illness]. Resilience is a human capacity to adapt swiftly and successfully to stressful or traumatic events and revert back to a positive state. It is commonly conceptualized as the ability to thrive despite experiencing adversity

Education And Training For Suicide Prevention In India, Amresh Srivastava

Amresh Srivastava

No abstract provided.

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 …

Closing Treatment Gaps In Management Of Suicide Behaviour: New Understanding- New Hope, Amresh Srivastava

Amresh Srivastava

TBC

Suicide Prevention.Movie, Amresh Srivastava

Amresh Srivastava

No abstract provided.

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

Amresh Srivastava

‘Poverty and social exclusion conference’ London, Ontario, October 23-24, presented during the conference of Lawson Health Care Institute’s conference ‘CUREA’ 24th October 2013

Title: Burden of stigma on mentally ill and social exclusion Amresh Shrivastava, Associate Professor of Psychiatry Western University, London, Ontario, Canada

Abstract 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, …

First Episode Is The Best Episode: Lessons And Limitations In Duration Of Untreated Psychosis (Dup) And Outcome In Schizophrenia, Amresh Srivastava, Larry Stitt, Meghana Thakar, Gurusamy Chinnasamy, Nilesh Shah

Amresh Srivastava

Background: Early intervention in psychosis is an opportunity. Research ahs shown that if any thing community members can do to prevent psychosis is to report early. This has opened newer vistas for understanding the complexity of brain and behaviour in schizophrenia. At the same time it has raised the bar of expectations regarding its correlation to outcome. It finally narrows down to meaningful public campaign for awareness, which will decide success of research to clinics in schizophrenia management. Duration of untreated psychosis (DUP) has emerged as a reliable predictor of outcome and provides credence to development of early intervention services. …

.General Practitioners Training: ( Second) A Strategic Response To Treatment Gaps For, Amresh Srivastava

Amresh Srivastava

General practitioners training: a strategic response to treatment gaps for suicide behaviour Amresh Shrivastava • Suicide is an international public heath problem, which impacts the most vulnerable of the world’s populations. • About one million people commit suicide and 10-20 times of these attempt it every year across the glob. • More than 90000 adolescents commit suicide every year while rate of attempted suicide every year. • .It is also among the top 20 leading causes of death, which is projected to contribute more than 2% to the global burden of disease by the year 2020 globally for all ages. …

General Practitioners Training: A Strategic Response To Treatment Gaps For Suicide Prevention, Amresh Srivastava

Amresh Srivastava

General practitioners training: a strategic response to treatment gaps for suicide behaviour Amresh Shrivastava • Suicide is an international public heath problem, which impacts the most vulnerable of the world’s populations. • About one million people commit suicide and 10-20 times of these attempt it every year across the glob. • More than 90000 adolescents commit suicide every year while rate of attempted suicide every year. • .It is also among the top 20 leading causes of death, which is projected to contribute more than 2% to the global burden of disease by the year 2020 globally for all ages. …

Early Identification Of Eating Disorder, Amresh Srivastava

Amresh Srivastava

Robbie Campbell MD FRCPC, Jill Mustin-Powell RN, Megan Johnston PhD, Miky Kaushal MD, Larry Stitt MSc, Amresh Srivastava MRCPsych FRCPC Purpose: Comorbidity of eating disorders and its behavioral traits are common amongst psychiatric patients. Eating disorders are often missed or misdiagnosed which leads to poorer clinical outcome and low functioning, though it is a treatable condition. Patients with eating disorders also tend to have severe psychopathology, which increases risk of suicide, duration of hospitalization and polypharmacy. The present study examines the presence of comorbid eating disorders and their behavioral symptoms in hospitalized adult psychiatric patients. Methods: The study was carried …

A New Brief Scale To Assess Suicidality: Scale For Impact Of Suicidality-Management, Assessment And Planning Of Care (Sis-Map- Brief Scanner), Amresh Srivastava, Megan Johnston, Miky Kaushal, Robbie Campbell, Charles Nelson

Amresh Srivastava

Purpose: In this study we examine merit of a short version (Brief Interview Screener (SIS-MAP-scn )of a previously developed and validated 108 item scale, known as ‘ Scale for Impact of Suicidality-Management, Assessment and Planning of Care ( SIS MAP), for rapid assessment in challenging clinical settings e.g. primary care and emergency room. Background: Generally suicide risk is assessed clinically and structured assessments optimize the direction for decision-making across various settings e.g. inpatient care, emergency rooms and crisis centers. We believe that measures with accurate and valid information should be based upon multifactorial risk-constituent domains, e.g. biological, social, psychological, environmental …

A Naturalistic Study Of Screening For Eating Disorder Amongst Psychiatric Patients, Amresh Srivastava, Miky Kaushal, Megan Johnston, Robbie Campbell

Amresh Srivastava

No abstract provided.

Eating Disorders Remain Undetected In Psychiatric Hospitalization: Study Of Electronic Chart Review Of 8000 Patients, Amresh Srivastava, Miky Kaushal, Megan Johnston, Robbie Campbell

Amresh Srivastava

No abstract provided.

Mental Health Of University Students: Perspectives For Intervention And Prevention: An Indo-Canadian Collaborative Project, Amresh Srivastava, Rahel Eynan, Ravi Shah, Laxaman Dutt, Shubhangi Parkar, Tss Rao, Dp Giridhar, Rakesh Bhandari, Nagesh Bhandari, Paul Link

Amresh Srivastava

Purpose: The study aimed to determine the levels of psychological distress of university students and examine teachers’ awareness and opinions concerning suicide prevention. Methods: The study used a two-phase, sequential mixed-method approach of converging quantitative and qualitative methodologies. In the quantitative study the 1a2-item General Health Questionnaire (GHQ-12) was used to measure psychological wellbeing in a student sample ( n=110 ). The qualitative study consisted of a focus group with students (n=200) and faculty members. (n=25). Results: The scores for the sample ranged between 0- 33 with a mean score of 10.25 (SD= 6.14). The majority of respondents (70.6%) endorsed …

Eating Disorders Remain Undetected In Psychiatric Hospitalization: Study Of Electronic Chart Review Of 8000 Patients, Amresh Srivastava, Miky Kaushal, Megan Johnston, Robbie Campbell

Amresh Srivastava

No abstract provided.

Screening For Eating Disorder Amongst Psychiatric Patients, Amresh Srivastava, Miky Kaushal, Megan Johnston, Robbie Campbell

Amresh Srivastava

No abstract provided.

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 …

The Reemergence Of Psychoneuroendocrinology In The Era Of Molecular Neuroscience, Genetics And Imaging, Amresh Srivastava

Amresh Srivastava

Though Psychiatric and neuroscience research has made revolutionary advancements, a number of challenges remain as a barrier in decoding the metrics of psychopathology which intern limits the clinical practice of personalized medicine. In last 20 years a unique direction of research has come to light which provides information about the intricate connections between various findings from the field of neuroimaging, cognition, neurochemistry, molecular biology, immunology and epigenetics. Neurohormores have clearly demonstrated their role in explaining this interrelationship and therefore a possible trajectory for development of mental disorders seem to be visible. Main thrust of investigation which have provided newer insight …

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 …