Psychiatric and Mental Health Commons^™

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 …

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 …

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.

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 …

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 …

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 …

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. …

: 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 …

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 …

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 …

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 …

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 …

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 …

Assessment In Crisis, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Switching And Selecting Atypical Antipsychotic Drugs: Quetiapine, Amresh Srivastava

Amresh Srivastava

No abstract provided.