Medicine and Health Sciences Commons^™

The Influence Of Depression-Ptsd Comorbidity On Health-Related Quality Of Life In Treatment-Seeking Veterans, Callista Forchuk, Anthony Nazarov, Renee Hunt, Brent Davis, Kate St. Cyr, J Donald Richardson

Psychiatry Publications

Objective: Posttraumatic stress disorder (PTSD) and depression substantially impair healthrelated quality of life (HRQOL) for many Canadian Armed Forces (CAF) veterans. Although PTSD and depression are highly comorbid, little is known about whether the disorders may interact in their association with HRQOL. We sought to investigate whether depressive symptoms modify the relation between PTSD and HRQOL in treatment-seeking veterans. Method: We accessed the clinical data of 545 CAF veterans aged 18 to 65 years who were seeking treatment at a specialized clinic in London, Ontario. We used hierarchical linear regression to assess the additive and multiplicative relations between depression and …

A Review Of The Pharmacological And Clinical Profile Of Newer Atypical Antipsychotics As Treatments For Bipolar Disorder: Considerations For Use In Older Patients., Akshya Vasudev, Sumit Chaudhari, Rickinder Sethi, Rachel Fu, Rachel M Sandieson, Brent P Forester

Psychiatry Publications

Bipolar disorder prevalence rates vary in the older adult population (defined as age ≥ 65 years), ranging from 1% in community dwellers to as high as 8-10% in hospital inpatients. Although older agents, including lithium and valproic acid, offer significant antimanic efficacy, as supported by a recent randomized controlled trial (RCT), there is growing interest in using atypical antipsychotics to treat bipolar disorder in older adults. Newer atypical antipsychotics are of interest based on their tolerability and efficacy in the general adult bipolar population. The aim of this review was to systematically examine efficacy and tolerability of newer atypical antipsychotics …

Depression And The Relationship Between Sleep Disturbances, Nightmares, And Suicidal Ideation In Treatment-Seeking Canadian Armed Forces Members And Veterans, Don Richardson, Lisa King, Kate St. Cyr, Philippe Shnaider, Maya L. Roth, Felicia Ketcheson, Ken Balderson, Jon D. Elhai

MacDonald Franklin OSI Research Centre

Background: Research on the relationship between insomnia and nightmares, and suicidal ideation (SI) has produced variable findings, especially with regard to military samples. This study investigates whether depression mediated the relationship between: 1) sleep disturbances and SI, and 2) trauma-related nightmares and SI, in a sample of treatment-seeking Canadian Armed Forces (CAF) personnel and veterans (N = 663). Method: Regression analyses were used to investigate associations between sleep disturbances or trauma-related nightmares and SI while controlling for depressive symptom severity, posttraumatic stress disorder (PTSD) symptom severity, anxiety symptom severity, and alcohol use severity. Bootstrapped resampling analyses were used to …

Music Therapy In Patients With Dementia And Behavioral Disturbance On An Inpatient Psychiatry Unit: Results From A Pilot Randomized Controlled Study., Joanna Thornley, Hussein Hirjee, Akshya Vasudev

Psychiatry Publications

The prevalence of dementia continues to grow worldwide due to an aging population and is projected to affect 65.7 million people by 2030 (World Health Organization, 2012). Behavioral and psychological symptoms of dementia (BPSD), including agitation, anxiety, aggression, depression, and psychosis, can occur in as much as 80% of the affected population, frequently necessitating psychiatric admission. Traditionally BPSD have been treated using pharmacological approaches. However, such medications could have serious adverse effects and additionally have limited efficacy in reducing such symptoms (Ballard et al., 2009).

A Training Programme Involving Automatic Self-Transcending Meditation In Late-Life Depression: Preliminary Analysis Of An Ongoing Randomised Controlled Trial., Akshya Vasudev, Amanda Arena, Amer M Burhan, Emily Ionson, Hussein Hirjee, Pramudith Maldeniya, Stephen Wetmore, Ronnie I Newman

Psychiatry Publications

: Late-life depression affects 2-6% of seniors aged 60 years and above. Patients are increasingly embracing non-pharmacological therapies, many of which have not been scientifically evaluated. This study aimed to evaluate a category of meditation, automatic self-transcending meditation (ASTM), in alleviating symptoms of depression when augmenting treatment as usual (NCT02149810). The preliminary results of an ongoing single-blind randomised controlled trial comparing a training programme involving ASTM with a wait-list control indicate that a 12-week ASTM programme may lead to significantly greater reductions in depression and anxiety severity. As such, ASTM may be an effective adjunctive therapy in the treatment of …

Trends In Psychotropic Dispensing Among Older Adults With Dementia Living In Long-Term Care Facilities: 2004-2013., Akshya Vasudev, Salimah Z Shariff, Kuan Liu, Amer M Burhan, Nathan Herrmann, Sean Leonard, Muhammad Mamdani

Psychiatry Publications

OBJECTIVE: Guidelines worldwide have cautioned against the use of antipsychotics as first-line agents to treat neuropsychiatric symptoms of dementia. We aimed to investigate the changes over time in the dispensing of antipsychotics and other psychotropics among older adults with dementia living in long-term care facilities.

METHODS: We used drug claims data from Ontario, Canada, to calculate quarterly rates of prescription dispensing of six psychotropic drug classes among all elderly (≥65 years of age) long-term care residents with dementia from January 1, 2004, to March 31, 2013. Psychotropic drugs were classified into the following categories: atypical and conventional antipsychotics, non-sedative and …

Brain Maturation, Poverty And Social Exclusion: Shifting Paradigms Of Psychopathology, Amresh Srivastava

Psychiatry Presentations

Abstract for lecture

Poverty is a major risk factor for mental disorders. Neuroimaging studies show path are breaking findings to explain why ppeople living in poverty suffer from improper development and maturation of brain due to neuronal loss. It sets in much before the child is born and leads to increased vulnerability for mental disorders.

Recent findings show that changes in brain structure and function due to lack of brain maturation is directly related to poverty. A number of these changes are end result of neuronal survival in the most fundamental neuronal matrix. These findings along with other biological correlates …

Severe Mental Illnesses: Training And Education, Amresh Srivastava

Psychiatry Publications

Amresh Srivastava

MD,MRCPsych,FRCPC

Associate Professore of Psychiatry

Western University

London.ON

Severe Mental Illnesses: Training and Education

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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 …

The Epidemic Of Mental And Neurological Health, Mohsyn I. Malik

Psychology Publications

This paper composes an image of modern mental and neurological health issues and looks to draw links to the current epidemic based on research and studies found online the internet and off-line. The goal is to examine what may be the underlying problem for a lot of these increases in mental health issues and neurodegenerative diseases and what are some promising clinical and sociocultural advances that may help. It explores problems such as the negative impact of the pharmaceutical giants, the increase in apathy in the work place and the general stigma towards mental disease. Through current research, the use …

Olanzapine-Induced Methylation Alters Cadherin Gene Families And Associated Pathways Implicated In Psychosis, Melkaye G. Melka, Christina A Castellani, Nagalingam Rajakumar, Richard O'Reilly, Shiva M Singh

Biology Publications

BACKGROUND: The complex aetiology of most mental disorders involves gene-environment interactions that may operate using epigenetic mechanisms particularly DNA methylation. It may explain many of the features seen in mental disorders including transmission, expression and antipsychotic treatment responses. This report deals with the assessment of DNA methylation in response to an antipsychotic drug (olanzapine) on brain (cerebellum and hippocampus), and liver as a non-neural reference in a rat model. The study focuses on the Cadherin/protocadherins encoded by a multi-gene family that serve as adhesion molecules and are involved in cell-cell communication in the mammalian brain. A number of these molecules …

The Co-Occurrence Of Ptsd And Dissociation: Differentiating Severe Ptsd From Dissociative Ptsd, Cherie Amour, Karen-Inge Karstoft, Don Richardson

MacDonald Franklin OSI Research Centre

Purpose

A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD.

Methods

The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity …

Improving Trainee Psychiatrist’S Handover: Standard Setting And Audit, Arun Gupta, Ruth Bevan, Akshya Vasudev

Psychiatry Publications

No abstract provided.

Septohippocampal Gabaergic Neurons Mediate The Altered Behaviors Induced By N-Methyl-D-Aspartate Receptor Antagonists., Jingyi Ma, Siew Kian Tai, L Stan Leung

Physiology and Pharmacology Publications

We hypothesize that selective lesion of the septohippocampal GABAergic neurons suppresses the altered behaviors induced by an N-methyl-D-aspartate (NMDA) receptor antagonist, ketamine or MK-801. In addition, we hypothesize that septohippocampal GABAergic neurons generate an atropine-resistant theta rhythm that coexists with an atropine-sensitive theta rhythm in the hippocampus. Infusion of orexin-saporin (ore-SAP) into the medial septal area decreased parvalbumin-immunoreactive (GABAergic) neurons by ~80%, without significantly affecting choline-acetyltransferase-immunoreactive (cholinergic) neurons. The theta rhythm during walking, or the immobility-associated theta induced by pilocarpine, was not different between ore-SAP and sham-lesion rats. Walking theta was, however, more disrupted by atropine sulfate in ore-SAP than …

Examining The Association Between Psychiatric Illness And Suicidal Ideation In A Sample Of Treatment-Seeking Canadian Peacekeeping And Combat Veterans With Posttraumatic Stress Disorder, Don Richardson, Kate St. Cyr, Alexandra M. Mcintyre-Smith, David Haslam, Jon D. Elhai, Jitender Sareen

MacDonald Franklin OSI Research Centre

Objective:

Our study examines the association between suicidal ideation and and self-reported symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), and alcohol use disorder (AUD) in a sample of treatment-seeking Canadian combat and peacekeeping veterans; and identifies potential predictors of suicidal ideation.

Methods:

Actively serving Canadian Forces and Royal Canadian Mounted Police members and veterans seeking treatment at the Parkwood Hospital Operational Stress Injury Clinic (n = 250) completed measures including the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, the Alcohol Use Disorder Identification Test, and the PTSD Checklist—Military Version (PCL-M) …

Psychosis In Indigenous Populations Of Cape York And The Torres Strait, Ernest M. Hunter, Bruce D. Gynther, Carrick J. Anderson, Leigh-Ann L. Onnis, Jeffrey R. Nelson, Wayne Hall, Bernhard T. Baune, Aaron R. Groves

Aboriginal Policy Research Consortium International (APRCi)

Objective: To describe and characterise treated psychotic disorders in the Indigenous populations of Cape York and the Torres Strait.

Design: Cross-sectional analysis of patients with a psychotic disorder identified by treating psychiatrists.

Setting and participants: Indigenous patients aged 􏰀 15 years in Cape York and Torres Strait communities receiving treatment for a psychotic disorder over 3 months in 2010.

Main outcome measures: Prevalence of psychosis diagnoses, intellectual disability, and substance use comorbidities.

Results: 171 patients were included. The prevalence rate in this population was 1.68%, higher for males (2.60%) than females (0.89%), and twice as high in the Aboriginal (2.05%) …

Beyond Early Intervention, Amresh Srivastava

Psychiatry Presentations

No abstract provided.

A Mi'kmaq First Nation Cosmology: Investigating The Practice Of Contemporary Aboriginal Traditional Medicine In Dialogue With Counselling – Toward An Indigenous Therapeutics, Kisiku Sa'qawei Paq'tism Randolph Bowers

Aboriginal Policy Research Consortium International (APRCi)

This paper explores from a Mi’kmaq and Aboriginal standpoint foundational knowledge in Indigenous therapeutics. Based on an eco-social-psycho-spiritual way of working, the article proposes Indigenous cultural models that open a window to a rich cultural repository of meanings associated with Indigenous cosmology, ontology and epistemology. The three layers of meaning, theory and practice within the symbolic ‘Medicine Lodge’ or ‘Place of The Dreaming’ give rise to ways of working that are deeply integrative and wholistic. These forms of Indigenous theory and practice have much to offer the counselling and complimentary health professions.

Psychoendocrinology (Thyroid Hormone) And Early Psychosis: Preliminary Findings, Amresh Srivastava, Megan Johnston, Lenore Purde, Robbie Campbell

Psychiatry Presentations

No abstract provided.

Serum Lipids And Suicidality In Early Psychosis: Is There A Connection? A Preliminary Study, Amresh Srivastava, Megan Johnston, Lenore Purde, Robbie Campbell

Psychiatry Presentations

No abstract provided.

Should 'Risk Syndrome Of Psychosis' Be Included In Dsm V As A Diagnosis? A Road Towards Preventive Psychiatry, Amresh Srivastava

Psychiatry Presentations

No abstract provided.

Enhancing Risk Assessment Across Mental Health Services, Amresh Srivastava, Megan Johnston, Charles Nelson

Psychiatry Presentations

No abstract provided.

Antipsychotics And Outcome In Schizophrenia, Amresh Srivastava, Anukant Mital

Psychiatry Presentations

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

Psychiatry Presentations

▪ 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

Psychiatry Presentations

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.

Current Understanding And Pharmacological Management Of Suicide Behavior In Clinical Setting, Amresh Shrivastava

Psychiatry Presentations

This presentation addresses these issues:
• Nature of problem in clinical settings
• Current understanding about suicide behavior (neurobiology)
• What can be done to deal with suicide in clinical settings
• Pharmacological management

Early Psychosis: A Novel Gateway For Suicide Prevention, Amresh Srivastava

Psychiatry Presentations

No abstract provided.

Should Schizoaffective Disorder Be Dropped From Dsm V, Amresh Srivastava

Psychiatry Presentations

No abstract provided.

Selecting Antidepressant Drugs For Management Of Depression In Primary Care (Part 1), Amresh Srivastava

Psychiatry Presentations

No abstract provided.

Selecting Antidepressant Drugs For Management Of Depression In Primary Care (Part 2), Amresh Srivastava

Psychiatry Presentations

No abstract provided.

Switching And Selecting Atypical Antipsychotic Drugs: Paliperidone, Amresh Srivastava

Psychiatry Presentations

No abstract provided.