6 results on '"Vijay, Sagar"'
Search Results
2. Proactive detection of people in need of mental healthcare: accuracy of the community case detection tool among children, adolescents and families in Sri Lanka
- Author
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Myrthe van den Broek, Puvaneswary Ponniah, P. Judy Ramesh Jeyakumar, Gabriela V. Koppenol-Gonzalez, John Vijay Sagar Kommu, Brandon A. Kohrt, and Mark J. D. Jordans
- Subjects
Proactive detection ,Gatekeeper approach ,Help-seeking ,Children ,Adolescents ,Mental health ,Pediatrics ,RJ1-570 ,Psychiatry ,RC435-571 - Abstract
Abstract Background Most children and adolescents in need of mental healthcare remain untreated even when services are available. This study evaluates the accuracy of a new tool, the Community Case Detection Tool (CCDT). The CCDT uses illustrated vignettes, two questions and a simple decision algorithm to support proactive community-level detection of children, adolescents and families in need of mental healthcare to improve help-seeking. Methods Trusted and respected community members in the Eastern Province of Sri Lanka used the CCDT in their daily routine. Children and families detected as potentially in need of mental healthcare based on utilizing the CCDT (N = 157, aged 6–18 years) were invited for a clinical interview by a mental health counsellor using the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). The CCDT results were compared against the results of the clinical interview. The concurrent validity and performance of the CCDT were also evaluated by comparing the CCDT outcomes against the Strengths and Difficulties Questionnaire (SDQ). Results 7 out of 10 children and families detected by community members using the CCDT were confirmed to be in need for treatment (positive predictive value [PPV] = 0.69; 0.75 when compared to the SDQ). Detections based on the family problem vignette were most accurate (PPV = 0.76), followed by the internalising problem vignette (PPV = 0.71) and the externalising problem vignette (PPV = 0.62). Conclusions The CCDT is a promising low-cost solution to overcome under-detection of children and families in need of mental healthcare. Future research should focus on evaluating the effectiveness, as well as additional strategies to improve help-seeking.
- Published
- 2021
- Full Text
- View/download PDF
3. Child and adolescent psychiatry training in Nepal: early career psychiatrists’ perspective
- Author
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Utkarsh Karki, Yugesh Rai, Gunjan Dhonju, Eesha Sharma, Preeti Jacob, John Vijay Sagar Kommu, and Shekhar P. Seshadri
- Subjects
Child and adolescent psychiatry ,Training ,Early career psychiatrists ,Nepal ,Low income country ,Pediatrics ,RJ1-570 ,Psychiatry ,RC435-571 - Abstract
Abstract Background Nepal is a developing low-income country in Southeast Asia. There is a huge burden of child and adolescent mental health (CAMH) in Nepal which has a population of around 29 million and 40–50% of the population comprises of children and adolescents. Child and Adolescent Psychiatry (CAP) has not been formally recognized as a subspecialty in Nepal and there is no standardized curriculum for CAP training. The objectives of the survey were to identify the current status of training, shortfalls and to explore the training experiences of early career psychiatrists (ECPs) in Nepal. Methods The participants were ECPs in Nepal. An online questionnaire was created consisting of 20 questions including 3 questions requiring an answer indicating a level of agreement scored on a ten-point scale. Questionnaire using google form was e-mailed with the uniform resource locator (URL). Respondents anonymously answered the questions. The survey was open from 01/01/2019 to 01/04/2019. Results Response rate was 83.69%. Around 42% (n = 32) were trainees in Doctor of Medicine (MD) Psychiatry and 58% (n = 45) of respondents had completed their MD Psychiatry. More than half of the ECPs had not received formal training specific to CAP. Seventy percent (n = 54) ECPs reported that their current workplace did not have a specific unit to address psychological problems in children and adolescents. However, 62% (n = 48) of ECPs came across 10 CAP cases per week. On a ten-point scale, mean score of ECPs confidence in diagnosing, management and overall confidence in CAP cases were 5.18 ± 1.56, 4.58 ± 1.59 and 4.67 ± 1.62 respectively. Fifty-four percent (n = 42) of respondents rated their training as limited and 74% (n = 57) of them wanted additional training in CAP. Psychological intervention, psychotherapy and a fellowship course were the additional training most of the ECPs wanted to receive. Conclusion Despite significant exposure to CAP patients in daily practice, ECPs self-evaluated their training as inadequate and there is no standardized CAP training program in Nepal for ECPs. The desire of ECPs to receive additional training in CAP is highly encouraging and positive. We advocate for the development and incorporation of CAP training in current psychiatry training to fulfill these unmet training needs in Nepal.
- Published
- 2020
- Full Text
- View/download PDF
4. Favourable short-term course and outcome of pediatric anxiety spectrum disorders: a prospective study from India
- Author
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Preeti Kandasamy, Satish C. Girimaji, Shekhar P. Seshadri, Shoba Srinath, and John Vijay Sagar Kommu
- Subjects
Anxiety disorder ,Children ,Adolescent ,Course ,Outcome ,Pediatrics ,RJ1-570 ,Psychiatry ,RC435-571 - Abstract
Abstract Background Although anxiety disorders are the most prevalent psychiatric disorders among children and adolescents, there is a paucity of research on the course and outcome of anxiety spectrum disorders in low and middle-income countries. Methods 60 children and adolescents aged 6–16 years with anxiety spectrum disorders attending the child and adolescent psychiatry department in a tertiary care center from India were included after taking written informed consent and assent in this prospective study conducted between April 2012 to May 2014. Assessments were done at baseline, 12 weeks and 24 weeks using pediatric anxiety rating scale, clinical global impression-severity, clinical global assessment scale and pediatric quality of life scale; MINI-KID (version 6.0) was used to examine remission status. Results Mean age of children was 12.68 years and mean duration of illness was 34.52 months. Follow-up rate at 24 weeks was 80% with a remission rate of 64.6%. Socio-demographic factors did not affect the baseline severity or course and outcome measures. Children with greater baseline severity and social phobia had a less favorable outcome at 24 weeks. Improvements made in the initial 12 weeks were maintained at 24 weeks follow up. These findings are in line with earlier studies from high-income countries. Limitations Small sample size, attrition, rater bias. Conclusion The study has shown a favorable outcome in children and adolescents with anxiety spectrum disorders receiving treatment-as-usual in a tertiary care setting. Adolescents who present with greater severity, comorbid with other anxiety disorders and depression at baseline require intensive intervention, and long-term follow up. There is a need for interventional research with specific focus on universal preventive programs for anxiety spectrum disorders that are feasible for delivery in low and middle-income countries.
- Published
- 2019
- Full Text
- View/download PDF
5. Proactive detection of people in need of mental healthcare: accuracy of the community case detection tool among children, adolescents and families in Sri Lanka
- Author
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Puvaneswary Ponniah, Mark J. D. Jordans, John Vijay Sagar Kommu, P. Judy Ramesh Jeyakumar, Gabriela V. Koppenol-Gonzalez, Brandon A. Kohrt, Myrthe van den Broek, and Anthropology of Health, Care and the Body (AISSR, FMG)
- Subjects
medicine.medical_specialty ,Proactive detection ,Concurrent validity ,RC435-571 ,Help-seeking ,Gatekeeper approach ,Adolescents ,Pediatrics ,RJ1-570 ,Forensic psychiatry ,Child and adolescent psychiatry ,medicine ,Children ,Sri Lanka ,Psychiatry ,Low-and middle-income countries ,Strengths and Difficulties Questionnaire ,Mental health ,Psychiatry and Mental health ,Vignette ,Family medicine ,Pediatrics, Perinatology and Child Health ,Sri lanka ,Psychology ,Research Article - Abstract
Background Most children and adolescents in need of mental healthcare remain untreated even when services are available. This study evaluates the accuracy of a new tool, the Community Case Detection Tool (CCDT). The CCDT uses illustrated vignettes, two questions and a simple decision algorithm to support proactive community-level detection of children, adolescents and families in need of mental healthcare to improve help-seeking. Methods Trusted and respected community members in the Eastern Province of Sri Lanka used the CCDT in their daily routine. Children and families detected as potentially in need of mental healthcare based on utilizing the CCDT (N = 157, aged 6–18 years) were invited for a clinical interview by a mental health counsellor using the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). The CCDT results were compared against the results of the clinical interview. The concurrent validity and performance of the CCDT were also evaluated by comparing the CCDT outcomes against the Strengths and Difficulties Questionnaire (SDQ). Results 7 out of 10 children and families detected by community members using the CCDT were confirmed to be in need for treatment (positive predictive value [PPV] = 0.69; 0.75 when compared to the SDQ). Detections based on the family problem vignette were most accurate (PPV = 0.76), followed by the internalising problem vignette (PPV = 0.71) and the externalising problem vignette (PPV = 0.62). Conclusions The CCDT is a promising low-cost solution to overcome under-detection of children and families in need of mental healthcare. Future research should focus on evaluating the effectiveness, as well as additional strategies to improve help-seeking.
- Published
- 2021
6. Child and adolescent psychiatry training in Nepal: early career psychiatrists’ perspective
- Author
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Yugesh Rai, Eesha Sharma, Gunjan Dhonju, John Vijay Sagar Kommu, Preeti Jacob, Shekhar P. Seshadri, and Utkarsh Karki
- Subjects
Early career psychiatrists ,medicine.medical_specialty ,lcsh:RC435-571 ,education ,Population ,Psychological intervention ,Computer-assisted web interviewing ,Subspecialty ,03 medical and health sciences ,0302 clinical medicine ,Nepal ,lcsh:Psychiatry ,030225 pediatrics ,Forensic psychiatry ,Child and adolescent psychiatry ,medicine ,Training ,Low income country ,Response rate (survey) ,education.field_of_study ,business.industry ,lcsh:RJ1-570 ,lcsh:Pediatrics ,Mental health ,030227 psychiatry ,Psychiatry and Mental health ,Family medicine ,Pediatrics, Perinatology and Child Health ,business ,Research Article - Abstract
BackgroundNepal is a developing low-income country in Southeast Asia. There is a huge burden of child and adolescent mental health (CAMH) in Nepal which has a population of around 29 million and 40–50% of the population comprises of children and adolescents. Child and Adolescent Psychiatry (CAP) has not been formally recognized as a subspecialty in Nepal and there is no standardized curriculum for CAP training. The objectives of the survey were to identify the current status of training, shortfalls and to explore the training experiences of early career psychiatrists (ECPs) in Nepal.MethodsThe participants were ECPs in Nepal. An online questionnaire was created consisting of 20 questions including 3 questions requiring an answer indicating a level of agreement scored on a ten-point scale. Questionnaire using google form was e-mailed with the uniform resource locator (URL). Respondents anonymously answered the questions. The survey was open from 01/01/2019 to 01/04/2019.ResultsResponse rate was 83.69%. Around 42% (n = 32) were trainees in Doctor of Medicine (MD) Psychiatry and 58% (n = 45) of respondents had completed their MD Psychiatry. More than half of the ECPs had not received formal training specific to CAP. Seventy percent (n = 54) ECPs reported that their current workplace did not have a specific unit to address psychological problems in children and adolescents. However, 62% (n = 48) of ECPs came across 10 CAP cases per week. On a ten-point scale, mean score of ECPs confidence in diagnosing, management and overall confidence in CAP cases were 5.18 ± 1.56, 4.58 ± 1.59 and 4.67 ± 1.62 respectively. Fifty-four percent (n = 42) of respondents rated their training as limited and 74% (n = 57) of them wanted additional training in CAP. Psychological intervention, psychotherapy and a fellowship course were the additional training most of the ECPs wanted to receive.ConclusionDespite significant exposure to CAP patients in daily practice, ECPs self-evaluated their training as inadequate and there is no standardized CAP training program in Nepal for ECPs. The desire of ECPs to receive additional training in CAP is highly encouraging and positive. We advocate for the development and incorporation of CAP training in current psychiatry training to fulfill these unmet training needs in Nepal.
- Published
- 2020
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