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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 …

Suicide Prevention: Education And Training For Mental Health Professional, Amresh Srivastava

Amresh Srivastava

RISK ASSESSMENT OF SUICIDE IN CLINICAL PRACTICE AMRESH SHRIVASTAVA1.

Suicide is a public health problem presents as the most serious psychiatric emergency. Identification and assessment of suicidality is a skill that every physician needs to have, skills for identification and intervention Risk assessments are done in number of settings like: emergency rooms, psychiatric outpatient, primary care, general medical wards, post-operative and intensive care settings, crisis centers, day hospitals for crisis beds, telephone helplines, psychiatric outpatients, psychiatric acute services, community psychiatry settings, early intervention programs, sometimes in special settings like jails, prisons, schools, workplaces and legal justice systems. In every setting …

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 …

Neuroendocrines In First Episode Schizophrenia, Amresh Srivastava

Amresh Srivastava

Amresh Shrivastava Environmental factors are acknowledged as key determinants of development of schizophrenia. Studies suggest that the altered expression of genes and proteins involved in numerous neurodevelopmental, metabolic and neurotransmitter pathways can result from inadequate amounts of modulators, transporters and, synthesizers. Advances in the prenatal period in the genesis of schizophrenia suggest that environmental factors and HPA axis may establish a vulnerability to the disease. Further, the onset of psychotic disorders may be associated with a higher rate of stress and change to the hippocampus. Thyroid hormone is a possible link between genes and environment. Its dysfunction has been observed …

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 Health, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Management Of Suicide Behaviour In Psychiatric Practice, Amresh Srivastava

Amresh Srivastava

Management of suicide behavior in psychiatric practice Amresh Shrivastava1 Running Title: Affiliations: 1 Department of Psychiatry, Associate Professor of Psychiatry and The University of Western Ontario, Associate Scientist, Lawson Health Research Institute London, ON, Canada, N6A 5C1 Correspondence: Regional Mental Health Care, 467 Sunset Drives, St. Thomas, Ontario, N5H 3V9, the University of Western Ontario, London, Canada E-mail: Amresh Srivastava* - dr.amresh@gmail.com

Suicide is a global public health problem, and its management in clinical practice remains complex and challenging. Studies show that about 26% of suicides are found within the mental health system. Out of these, 14% commit suicide during …

Neuroendocrine And Gene-Environment Interaction In Psychiatric Disorders: Current Concepts", Amresh Srivastava

Amresh Srivastava

Abstract Neuroendocrine and gene-environment interaction in psychiatric disorders: current concepts" Amresh Shrivastava, MD The psychiatric disorders are etiologically complex involving both heritable and non-heritable factors. Recent research has indicated that environmental factors, including psychosocial factors, play an important role in manifestation of symptoms. The gap between understanding of those who develop psychiatric illness and those who do not amongst the subgroup of genetic as well as clinical high risk candidates in partly explained by role of environmental factors. These, social, psychological, ecological and cultural factors possibly determine the modulation of biological factors at the level of gene-expression and neuroendocrinal systems. …

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 …

: A Neurobiological Model For Pathways Of Transition To Psychosis Due To Cannabis, Amresh Srivastava

Amresh Srivastava

Cannabis has been implicated as a risk factor for the development of schizophrenia, although the exact biological mechanisms remain unclear. Purpose of this presentation is to explore trajectory for psychosis due to cannabis based upon a neurobiological model. A selective Pubmed search was carried out to construct a model of pathway based upon our hypothesis. The hypothesis for this conceptual paradigm is that neurobiological changes exist and cannabis metabolites modulate these changes in a sequential manner from genetic expression, environmental and biological interaction and neurochemical dysfunctions leading to cognitive dysmatria. Dopamine remains a final common pathway which leads to core …

Global Mental Health, Amresh Srivastava

Amresh Srivastava

No abstract provided.

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 …

Quantification Of Stigma For Clinical Assessment In Psychiatric Practice’ - A Paradigm Shift In Anti-Stigma Intervention: Using Newly Developed Scale (Stigma Quantification Scale ‘Sqs’)., Amresh Srivastava

Amresh Srivastava

Purpose: Objective of the project was to develop a quantification tool for measurement of stigma in clinical practice for the purpose of identifying patients who have suffered severe stigma with the hopes of identifying and treating stigma related issues. Methods: Our tool which includes 49 items, quantifies four domains of stigma: (1) Personal; (2) Family; (3) Social; and (4) Illness. In addition, the items are distributed into three subscales: (a) self-experience; (b) illness related consequences; and (c) coping strategies. Results: In this pilot study conducted in India, we present the scale details and results. We found that as age increased …

Re-Hospitalization Of Psychiatric Patients: The Patients, Or The Illness And Treatment?, Amresh Srivastava, Robbie Campbell, Megan Johnston, Ruth Mooser, Larry Stitt

Amresh Srivastava

Purpose: The goal of this project was to find out why psychiatric patients get hospitalised repeatedly. Studies have found that repeated hospitalization leads to economic drain, disability, poor outcome, stigma and discrimination. Hospitalization consumes more than 90% of mental health budgets. Identifying the potential risk factors for repeated hospitalization, interrelationships between risk factors, and vulnerability will help us take the appropriate measures to prevent hospitalization and promote care in the community. Logistically, there are three possible factors which may lead to repeated hospitalization: (1) Characteristics of the patient; (2) Nature of the illness; and (3) The management of the illness …

Dimensions Of Suicidality: Analyzing The Domains Of The Sis-Map Suicide Risk Assessment Instrument And The Development Of A Brief Screener, Megan Johnston, Charles Nelson, Amresh Shrivastava

Amresh Srivastava

This study aimed at validating the domains of suicidality assessed by the Scale for Impact of Suicidality—Management, Assessment and Planning of Care (SISMAP) and creating a brief screener based on the full scale. A total of 50 individuals with suicidal ideation were given the SIS-MAP interview. Support was found for these domains of suicide risk; in particular, the subscales of ideation and protective factors for suicide risk were highly reliable. For each domain of suicidality, items most predictive of total risk index scores were selected to create a brief screener aimed at expediting the assessment process. The screener was reliable, …

Suicidal Ideation In Callers To A Crisis Hotline In Mumbai,, Amresh Srivastava, Megan Johnston, Larry Stitt, Meghana Thanksr, Sunita Iyer, Nilesh Shah, David Lester

Amresh Srivastava

Suicidal ideation in callers to a crisis hotline in Mumbai, India Amresh K. Shrivastava1,2, Megan Johnston3, Larry Stitt4, Meghana Thakar5, Sunita Iyer6, Nilesh Shah7 and David Lester8* 1Silver Mind Hospital and Mental Health Foundation of India, (PRERANA Charitable Trust) Mumbai. 2Department of Psychiatry, University of Western Ontario, London, Canada. 3Department of Psychology, University of Toronto, 100 St. George St., Toronto, Ontario, Canada, M5S 2M2. 4Biostatistical Support Unit, Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada. 5Silver mind Hospital, Mumbai, Currently, Child and Adolescent Mental Health Practitioner, Lambeth CAMHS Early Intervention Team, South London and Maudsley …

Experience And Evaluation Of Hospital-Based Training Of University Teachers For Suicide Prevention In Mumbai, India, Amresh Srivastava

Amresh Srivastava

Amresh Shrivastava, Shubhangi Parkar, Nilesh Shah Background In India suicide rates high amongst student’s population with rising numbers of student’s suicide. The National Crime Research Bauru (NCRB) the Government of India reopots that approximately 2.% suicide takes place due to failure in examination, needless to say it remains grossly underreported due to several causes.eg. legal hassels The intervention strategy for dealing with mental health issues of students is particularly dependent upon awareness about suicide amongst the parsons who are in direct touch with them. The teachers of the colleges are in an advantageous position because they are in direct touch …

Measurement Of Clinical Risk Of Stigma And Discrimination Of Mental Illnesses, Amresh Srivastava

Amresh Srivastava

Measurement of Clinical Risk of Stigma and Discrimination of Mental Illnesses using: ‘Quantification of Stigma’ scale: preliminary findings Short title: Quantifying clinical risk of stigma for clinical practice Authors: Amresh Shrivastava1, Yves Bureau2, Nitika Rewari3, & Megan Johnston4 ……..5 Nilesh Shah 6 Affiliations 1. Executive Director: Mental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, Mumbai, India; Currently at The University of Western Ontario, Dept. of Psychiatry; and Associate Scientist at Lawson Health Research Institute, London, Canada. 2. Research Scientist (Associate Scientist/Director of Inferential Statistics-Imaging) Lawson Health Research Institute 268 Grosvenor Street, Room E5-136 London, Ontario, Canada …

Resilience, Psychopathology And Rehospitalization, Amresh Srivastava

Amresh Srivastava

Purpose: The goal of the project was to determine why patients are being hospitalized repeatedly within an acute psychiatric facility. Past studies have found repeated hospitalization leads to economic drain, disability, poor outcome, stigma and discrimination. Repeated hospitalizations are one of the main causes of disability and dysfunction amongst the mentally ill as well as consuming more than 90 % of the mental health budget. This drain deprives consumers of a major part of allocated health resources. Identifying the potential risk factors for repeated hospitalization, interrelationships between risk factors, and vulnerability will help us take the appropriate measures to prevent …

Cannabis And Psychosis: Transition To Psychosis, Amresh Srivastava, Kristen , Terpstra, Yves Bureau

Amresh Srivastava

Cannabis has been implicated as a risk factor for the development of schizophrenia, however, but the pathway of cannabis causing psychosis is not well understood. It appears that cannabis does not cause any structural changes per say but deficits in areas of the brain responsible for memory and emotion do show some changes. Recent studies suggest that cannabinoids such as CB1 have a pharmacological profile similar to that of atypical antipsychotic drugs. This mechanisms may involve dopamine, GABA, and glutamate neurotransmission; It is still not known if these changes are transitory or permanent, and whether or not they contribute to …

Measurement Of Clinical Risk Of Stigma And Discrimination Of Mental Illnesses, Amresh Srivastava, Yves Bureau, Nitika Rewari, Megan Johnston, Arman Panday, Nilesh Shah

Amresh Srivastava

Abstract

Background: Stigma and discrimination continue to be a reality in the lives of people suffering from mental illness, particularly schizophrenia, and prove to be some of the greatest barriers to access care, continue to remain under care, and regain a normal lifestyle and health. Research advances have defined stigma, assessed its implications and have even examined intervention strategies for dealing with stigma. The delay in treatment due to stigma causes potential complications like suicide, violence, harm to others and deterioration in capacity to look after one’s physical health. These are preventable clinical complications. In order to deal with the …

Transition To Psychosis In Cannabis Abusers, Amresh Srivastava

Amresh Srivastava

Transition to psychosis in Cannabis abusersSchizophrenia is a debilitating disease of major public health importance, the incidence of which shows prominent worldwide variation (up to fivefold) and is about 40% greater in men than in women. Furthermore, epidemiological studies have shown that the incidence is higher among those who grow up in urban areas and among migrants. Recent evidence indicates that, although the neurochemical origins of schizophrenia do not necessarily lie in dopamine dysregulation, this operates as the final common pathway underlying positive psychotic symptoms and may also play a role in negative and cognitive symptoms. The last few years …

Transition To Psychosis In Cannabis Abusers, Amresh Srivastava

Amresh Srivastava

Transition to psychosis in Cannabis abusersSchizophrenia is a debilitating disease of major public health importance, the incidence of which shows prominent worldwide variation (up to fivefold) and is about 40% greater in men than in women. Furthermore, epidemiological studies have shown that the incidence is higher among those who grow up in urban areas and among migrants. Recent evidence indicates that, although the neurochemical origins of schizophrenia do not necessarily lie in dopamine dysregulation, this operates as the final common pathway underlying positive psychotic symptoms and may also play a role in negative and cognitive symptoms. The last few years …

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 …

Study Of Negatives Symptoms In First Episode Schizophrenia*, Vivek Bambole, Nilesh, Shah, Shushma Sonavane, Megan , Johnston, Amresh Srivastava

Amresh Srivastava

Background: Prevalence of negative symptoms in the early phase of schizophrenia remains uncertain. Ne- gative symptoms are the primary cause of long term disability and poor functional outcome. The purpose of this study is to examine the presence of negative symptoms in patients with fist episode psychosis in schizophrenia who were hospitalized. Methods: Nega- tive symptoms were measured in 72 patients present- ing with FEP using the scale for assessment of nega- tive symptoms (SANS) and ascertained diagnosis us- ing DSM-IV. Prevalence of SANS items and sub- scales were examined for both schizophrenia and bi- polar disorder. Results: This study …

Training And Education For Suicide Prevention (Human Resource Development) In Lmic, Amresh Srivastava

Amresh Srivastava

Video

Description of the project: Background: Suicide is an international public health issue. Barriers to suicide prevention include lack of resources, access to care, lack of human resources (services and mental health care professionals),) stigma, lack of awareness and cultural and geographical factors. Most important amongst these barriers is lack of manpower for setting up services for identification, intervention and prevention of suicide. In most of the places either professional are not available or available professions lack the skills to identify and manage suicidal patients. Suicide is one of the leading causes of premature death worldwide and claims the lives …

Pathways To Psychosis In Cannabis Abuse, Amresh Srivastava

Amresh Srivastava

Cannabis has been implicated as a risk factor for the development of schizophrenia, but the exact biological mechanisms remain unclear. In this review, we attempt to understand the neurobiological pathways that link cannabis use to schizophrenia. This has been an area of great debate; despite similarities between cannabis users and schizophrenia patients, the evidence is not sufficient to establish cause-and-effect. There have been advances in the understanding of the mechanisms of cannabis dependence as well as the role of the cannabinoid system in the development of psychosis and schizophrenia. The neurobiological mechanisms associated with the development of psychosis and effects …

Disulfiram In The Management Of Alcohol Dependence: A Comprehensive Clinical Review, Amresh Srivastava

Amresh Srivastava

ABSTRACT Disulfiram remains a viable option as a treatment for alcohol dependence and has been shown in recent studies to be successful in treating patients with alco- hol dependence in a manner that is superior to both naltrexone and acamprosate. It is also useful in dual diagnosis patients and those with co-morbid cocaine and alcohol dependence. Although disulfiram’s me- chanism of action in alcohol dependence was long thought to be its effects as a psychological deterrent, more recent studies have uncovered potential anti- craving effects as well. Recent reviews exhort to the importance of supervised disulfiram therapy in high- lighting …

Extrapyramidal Symptoms In 10 Years Of Long Term Treatment Of Schizophrenia: Independent Of Psychopathology And Outcome, Amresh Srivastava

Amresh Srivastava

Extrapyramidal Symptoms in 10 Years of Long Term Treatment of Schizophrenia: Independent of Psychopathology and Outcome Amresh Srivastava1, Megan Johnston2, Kristen Terpstra3, Larry Stitt4, Avinash De Sousa5*, Nilesh Shah6 1Department of Psychiatry, Elgin Early Intervention Program for Psychosis, The University of Western Ontario, Ontario, Canada, and Mental Health Resource Foundation, Mumbai, Maharashtra, India, 2.Department of Psychology, University of Toronto, 100 St. George St., Toronto, Ontario, Canada, M5S 3G3 Ontario, London, Ontario, Canada N6A 5C1 5Research Officer, Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai 6 Professor and Head, Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai: One of …