68 research outputs found
Suicide risk in first episode psychosis: A selective review of the current literature
No full textMany studies have confirmed that the risk of suicide in patients with first-episode psychosis (FEP) is high, and high rates of premature mortality, particularly from suicide, may occur in the early phases of schizophrenia. However, suicide rates are difficult to measure in FEP patients, even in carefully defined samples, and there is relatively little specific information about the risk of suicide at illness onset or retrospectively concerning the untreated psychotic period. This selected review of the literature investigates suicidal behaviour with particular regard to severe suicidality (plans and attempts) and risk factors associated with suicide in FEP patients. A search was performed to identify all papers and book chapters during the period 1965-2010, and approximately 100 studies met the inclusion criteria. Most of evidence suggests that risk of suicidal behaviour is relatively high in FEP patients. The research reports highlight the need for universal, comprehensive, public mental health interventions aimed, not only toward early detection, but also toward the rapid engagement in treatment of people with psychoses. These interventions should include an adequate assessment of suicidal behaviour in patients with FEP, and an examination of the efficacy of specific components of the interventions. © 2011 Elsevier B.V
Electroencephalographic abnormality and clinical response in patients with first-episode schizophrenia treated with clozapine
No full textObjective: Clozapine is seen as a gold standard for treatment refractory schizophreniahowever, it is not recommended for the treatment of first-episode psychosis mainly due to concerns of severe side effects. An indicator for response holds tremendous clinical value to select patients who can benefit from clozapine, safely. EEG abnormality has been reported to be one such parameter, yet the definite conclusion of the nature of EEG changes and its predictive value remains undetermined. The present study was undertaken to examine electroencephalographic (EEG) abnormalities and clinical response subsequent to clozapine therapy in schizophrenia. Methods: A total of 80 first-episode patients were recruited for a 12 week study, from a tertiary care centre in Mumbai, India. First episode was defined as an illness of less than 2 years duration and first hospitalization since illness. EEG abnormalities, psychopathology, and positive and negative symptoms were examined at baseline and again after 12 weeks of clozapine treatment. Results: There were some types of EEG abnormalities found in pretreatment state in at least two-thirds of patients. The number of patients showing EEG abnormality at the end of the 12 weeks of treatment increased significantly, which included theta (?) frequency, slow waves, and sharp waves. Symptomatically, significant improvement was seen in both positive as well as negative symptoms scores. However, there was no significant correlation between EEG changes and clinical outcome. Conclusion: There was significant abnormality in the number of patients exhibiting EEG abnormalities. Baseline pretreatment EEG abnormalities were present in a considerable number of patients, and these EEG abnormalities did not significantly correlate with clinical improvement, except suggesting a trend towards such correlation. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 30-38
Research progress in the understanding and implications of stigma related to mental health
No full textStigma is neither new nor an isolated condition for people suffering from mental as well as physical disorders. It is regrettable that scientists, researcher, philosophers, and community leaders have been silent for a long time in recognizing and dealing with it. However, during the past 20–30 years, significant progress has taken place in stigma research, the world over including India. From research done in India, there is clear evidence that: stigma is not merely a social condition. Convergence of social, mental, and physical disorders around stigma has far-reaching consequences on risk and health outcomes. The present paper looks at the position of stigma in mental health from an Indian perspective. The research done on stigma in India is reviewed, and certain recommendation for the management and eradication of stigma are elucidated. Stigma in specific conditions such as schizophrenia, substance abuse, and child sexual abuse are also addressed. The WHO guidelines and Mayo clinic guidelines to eradicate are used as a basis to be applicable to the Indian scenario. We examine how a life of an individual is affected with stigma, how mental health advancement has changed or not changed negative impact of stigma on patients and finally how stigma is measured and minimized, mainly for work done in India
Book Review: General Psychiatry: Working with Families of Psychiatric Inpatients: A Guide for Clinicians
No full text
Brain-Derived neurotrophic factor and suicide in schizophrenia: Critical role of neuroprotective mechanisms as an emerging hypothesis
No full textSuicide is a common occurrence in psychiatric disorders and is a cause of increased healthcare utilization worldwide. Schizophrenia is one of the most common psychiatric disorders worldwide and posited to be seen in 1% of the population worldwide. Suicide is a common occurrence in schizophrenia with 25%–30% patients with schizophrenia attempting suicide and 8%–10% completing it. There is a need for valid biological markers to help clinicians identify patients with schizophrenia that may be at a risk of suicide and thus help in them receiving better care and interventions at the earliest even before a suicide attempt occurring. There are clear neurobiological changes at a genetic, neuroimaging, and neurochemical level that occurs in patients with schizophrenia that attempt suicide. There is a new theory that postulates neuronal plasticity and neuroprotection to have a role in the biological changes that ensue when suicidal thoughts and feelings occur in patients with schizophrenia. Neurotrophic growth factors like brain-derived neurotrophic factor (BDNF) have been documented to play a role in the protection of neurons and in the prevention of neurobiological changes that may lead to suicide both in schizophrenia and depression. The present paper presents a commentary that looks at the role of BDNF as a protective factor and neurobiological marker for suicide in schizophrenia
Early intervention of psychosis and re! ections for programmes in Indian
No full textEarly intervention of psychosis and re! ections fo
Clozapine response and pre-treatment EEG-is there some kind of relationship
No full textBackground: Clozapine has been used widely in the management of treatment-resistant schizophrenia. The present study aims at determining whether pre-treatment electroencephalography (EEG) abnormalities would serve as a marker for response to clozapine treatment. Subjects and Methods: This was a cross-sectional study done in a tertiary care center in Mumbai where patients diagnosed with schizophrenia using DSM-IV criteria and resistant schizophrenia using Kane criteria were assessed using EEG prior to starting clozapine treatment. They were rated for symptomatic improvement using the Positive and Negative Syndrome Scale (PANSS) along with Clinical Global Improvement for Severity (CGI-S). The results were statistically analysed and presented. Results: 55 out of the 80 patients in the study showed baseline EEG abnormalities. The mean duration of illness in the patients were 2.65 years. Slow wave and background EEG abnormalities were common in pre-treatment EEG. 36.4% patients in the study showed clinical response. Patients with negative symptoms and baseline EEG abnormalities showed better response. Conclusions: The study was circumscribed and had many limitations due to a small sample size. The relation between pre-treatment EEG abnormalities and clozapine response could not be statistically correlated and it could not be ascertained to be a marker for response to clozapine therapy
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