Psychiatry and Psychology Commons^™

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. …

Baseline Serum Prolactin In Drug-Naive, Firstepisode Schizophrenia And Outcome At Five Years: Is It A Predictive Factor?, Amresh Srivastava, Megan Johnston, Yves Bureau, Nilesh Shah

Amresh Srivastava

Objective: Serum prolactin is influenced by antipsychotic use but its relationships with psychopathology and general functioning are not clear. This study aimed to assess these relationships. Design: Serum prolactin levels were measured in patients with schizophrenia before being treated with antipsychotics and at various follow-up points. Setting: The study was conducted in a nongovernmental psychiatric treatment center in Mumbai, India. Participants: The participants included 30 male and 30 female drug-naïve patients with schizophrenia and 31 control participants. Measurements: The severity of psychopathology at baseline, three weeks, six weeks, and five years following treatment was assessed using a modified Brief Psychiatric …

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 …

Predictors Of Long-Term Outcome Of First-Episode Schizophrenia: A Ten-Year Follow-Up Study, Amresh Shrivastava, Nilesh Shah, Megan Johnston, Larry Stitt, Meghana Thakar

Amresh Srivastava

Objective: Schizophrenia is a severe mental disorder for which final outcomes continue to be unfavorable. The main objectives of this research were to examine and determine the baseline predictors of outcome status of first-episode schizophrenia in a long-term follow-up of ten years and of recovery ten years later.

Materials and Methods: The study was carried out in a non-governmental, psychiatric hospital and participants consisted of patients available for assessment ten years following their initial diagnosis. Outcome was assessed on clinical and social parameters. Clinical measures of outcome included psychopathology, hospitalization, and suicidality. Social parameters included quality of life functioning, employability, …

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 …

Cognitive Neurosciences: A New Paradigm In Management And Outcome Of Schizophrenia, Amresh K. Shrivastava, Megan E. Johnston

Amresh Srivastava

No abstract provided.

Predictors And Characteristics Of Response And Nonresponse: A Ten Year Follow-Up Of First Episode Schizophrenia In Mumbai, Amresh Shrivastava, Nilesh Shah, Megan Johnston, Larry Stitt, Meghana Thakar, Gurusamy Chinnasamy

Amresh Srivastava

▪ It is not clearly known what predicts good long-term outcome in first episode schizophrenia and what the characteristics are that differentiate patients who do and do not show good response ▪ We attempted to find the characteristics and predictors of good out-come for patients who presented with severe psychopathology and were hospitalized in their first episode psychosis in a tertiary psychiatric hospital in the city of Mumbai ▪ 101 patients of first episode schizophrenia were assessed at hospitalization, and reassessed at ten years ▪ The data was analyzed on 13 outcome parameters for predictors and characteristics of good outcome, …

Predictors And Characteristics Of Response And Nonresponse: A Ten Year Follow-Up Of First Episode Schizophrenia In Mumbai, Amresh Shrivastava, Nilesh Shah, Megan Johnston, Larry Stitt, Meghana Thakar, Gurusamy Chinnasamy

Amresh Srivastava

▪ It is not clearly known what predicts good long-term outcome in first episode schizophrenia and what the characteristics are that differentiate patients who do and do not show good response ▪ We attempted to find the characteristics and predictors of good out-come for patients who presented with severe psychopathology and were hospitalized in their first episode psychosis in a tertiary psychiatric hospital in the city of Mumbai ▪ 101 patients of first episode schizophrenia were assessed at hospitalization, and reassessed at ten years ▪ The data was analyzed on 13 outcome parameters for predictors and characteristics of good outcome, …

Do Atypical Antipsychotics Differ In Determining Long-Term Outcome Of First Episode Schizophrenia? A Naturalistic Outcome Study In India, Amresh Srivastava, Nilesh Shah, Megan Johnston, Larry Stitt, Meghana Thakar, Gurusamy Chinnasamy, Anukant Mital

Amresh Srivastava

Antipsychotic medications form the mainstream of treatment in schizophrenia. These drugs have several short term as well long term advantage. It is not known if atypical antipsychotics have the long-term effect in improving outcome and meeting expectations (1,2,3). The present study examined usage and association of antipsychotics drugs with clinical outcome a long-term naturalistic study.

Predictors And Characteristics Of Response And Nonresponse: A Ten Year Follow-Up Of First Episode Schizophrenia In Mumbai, Amresh Shrivastava, Nilesh Shah, Megan Johnston, Larry Stitt, Meghana Thakar, Gurusamy Chinnasamy

Amresh Srivastava

▪ It is not clearly known what predicts good long-term outcome in first episode schizophrenia and what the characteristics are that differentiate patients who do and do not show good response ▪ We attempted to find the characteristics and predictors of good out-come for patients who presented with severe psychopathology and were hospitalized in their first episode psychosis in a tertiary psychiatric hospital in the city of Mumbai ▪ 101 patients of first episode schizophrenia were assessed at hospitalization, and reassessed at ten years ▪ The data was analyzed on 13 outcome parameters for predictors and characteristics of good outcome, …

Persistent Suicide Risk In Clinically Improved Schizophrenia Patients: Challenge Of The Suicidal Dimension, Amresh Shrivastava, Megan Johnston, Nilesh Shah, Marco Innamorati, Larry Stitt, Meghana Thakar, David Lester, Maurizio Pompili

Amresh Srivastava

BACKGROUND: Suicide is a major problem in schizophrenia, estimated to affect 9%-13% of patients. About 25% of schizophrenic patients make at least one suicide attempt in their lifetime. Current outcome measures do not address this problem, even though it affects quality of life and patient safety. The aim of this study was to assess suicidality in long-term clinically improved schizophrenia patients who were treated in a nongovernmental psychiatric treatment centre in Mumbai, India.

METHOD: Participants were 61 patients out of 200 consecutive hospitalized first-episode patients with schizophrenia diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders who were …

Early Intervention In Psychotic Disorders: Challenges And Relevance In The Indian Context, Matcheri Keshavan, Amresh Shrivastava, Bangalore Gangadhar

Amresh Srivastava

Over the last two decades, there has been an increasing interest in the concept of early intervention (EI) in psychotic disorders, notably schizophrenia. Several lines of research underlie this emerging paradigm shift: (a) an increasingly well-established association between the duration of prolonged untreated illness and poor outcome; (b) evidence of progressive neurobiological changes in the early course of schizophrenia both in the pre-psychotic and psychotic phases, as evidenced by brain imaging studies in schizophrenia; and (c) emerging data, albeit preliminary, suggesting the efficacy and effectiveness of EI programs in improving the outcome in these patients. Mental health service systems across …

Response, Remission & Recovery: Need To Review Outcome Measures For Schizophrenia, Amresh Shrivastava, Nilesh Shah

Amresh Srivastava

Schizophrenia is a complex neurobehavioral disorder known to be associated with poor outcome. It causes significant disability in patients and burden of care amongst relatives. Outcome in developing countries has been reported to be far better than western world, which has come into scientific scanner recently. Wide gap exists between expectations of outcome amongst patients, relatives, caregivers and professionals, which is possibly because of limitations in measurements tools. Significant number of patients remain marginalized without improvement in social & occupational functioning preventing their integration into mainstream of society despite 'clinically reported good outcome' and significant advancement in treatments. The contemporary …

Should Schizoaffective Disorder Be Dropped From Dsm V, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Should Schizoaffective Disorder Be Dropped From Dsm V, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Schizophrenia: General Findings And Current Status, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Schizophrenia: General Findings And Current Status, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Relapse Prevention In Schizophrenia, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Cognition As An Outcome Measure In Schizophrenia, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Mood Symptoms As Comorbidity In Schizophrenia, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Differential Characteristics Of “Good Outcome Schizophrenia” In A Long-Term Ten Years Study, Mumbai, India, Amresh Srivastava, Meghan Thakar, Nilesh Shah, Larry Stitt

Amresh Srivastava

No abstract provided.

Outcome In Schizophrenia: How Good Is "Good Outcome" Schizophrenia In Long-Term In Developing Countries, Amresh Srivastava, Meghan Thakar, Nilesh Shah, Larry Stitt

Amresh Srivastava

No abstract provided.

Atypical Antipsychotics And Cognitive Enhancement In Schizophrenia: The Current Status, 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 …

Identifying Schizophrenia: Paradigm Shift ‘The Uhr Research’, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Stigma And Discrimination: The Mumbai Experience, Amresh Srivastava

Amresh Srivastava

Title: Stigma & Discrimination: The Mumbai Experience

Main Author: Amresh Shrivastava MD, DPM, MRCPsych, University of Western Ontario, London, Ontario, Canada.

Co-Authors: Gopa Sarkhel, MA, Iyer Sunita MA, Thakar Meghana MA, Shah Nilesh, MD, DPM

Address of Presenter: Executive Director, Mental health foundation of India (PRERANA Charitable Trust) Mumbai, India; Currently at Department of Psychiatry, The University of Western Ontario, London, Ontario, Canada Address: Regional mental health care, 467 Sunset Drive, St. Thomas, N5N 3V9, St. Thomas, Ontario, Canada Phone: 1-5196318510; Fax: 1-519-631-2512. E-mail: amresh.edu@gmail.com

Background: People with schizophrenia suffer from stigma and discrimination to a great extent, and this …