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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 …

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 : 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

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 …

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 …

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 …

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 …

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 …

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” …

Complexity And Limitations Of Stress-Endocrine Research In Mental Health, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Interface Of Cannabis And Early Psychosis--Priorities In Research And Service Development, Amresh Srivastava

Amresh Srivastava

Introduction: cannabis continues to affect mental health. Its abuse is on rise globally. In Canada a rise by 30% in last ten years has been observed in high school students. Interrelationship of cannabis with psychosis and schizophrenia is a complex one. Cannabis is highly comorbid with psychosis, & related to functional disability and outcome. It poses several challenges in understanding causal relationship for comorbidity, underlying neurochemical basis and specifics of service development. Prevalence of Cannabis varies from 20 to 50% early psychosis. Objective of this paper is to review available literature to identify challenges for newer targets of research and …

Assessment In Crisis, Amresh Srivastava

Amresh Srivastava

No abstract provided.

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

Amresh Srivastava

No abstract provided.