195 results on '"Trivedi JK"'
Search Results
2. Chapter-37 Contributions of Major Professional Bodies
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Trivedi, JK, primary
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- 2012
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3. Pharmacological Treatment of Psychosexual Disorders
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Trivedi, JK, primary and Tandon, Rajul, additional
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- 2005
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4. Twelve-month prevalence and treatment gap for common mental disorders: Findings from a large-scale epidemiological survey in India
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Sagar, Rajesh, primary, Pattanayak, RamanDeep, additional, Chandrasekaran, R, additional, Chaudhury, PranitK, additional, Deswal, BalbirS, additional, Lenin Singh, RK, additional, Malhotra, Savita, additional, Nizamie, SHaque, additional, Panchal, BharatN, additional, Sudhakar, TP, additional, Trivedi, JK, additional, Varghese, Mathew, additional, Prasad, Jagdish, additional, and Chatterji, Somnath, additional
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- 2017
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5. Prescription pattern of antidepressants in five tertiary care psychiatric centres of India
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Tripathi, Adarsh, primary, Avasthi, Ajit, additional, Desousa, Avinash, additional, Bhagabati, Dipesh, additional, Shah, Nilesh, additional, Kallivayalil, RoyAbraham, additional, Grover, Sandeep, additional, Trivedi, JK, additional, and Shinfuku, Naotaka, additional
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- 2016
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6. Neurocognitive deficits in obsessive compulsive disorder: A state or trait phenomenon?
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Vaish, Supriya, primary, Dalal, PK, additional, Sharma, Sachin, additional, and Trivedi, JK, additional
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- 2014
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7. Welcome biological breakthroughs, supply psychosocial insights
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Tripathi, Adarsh, primary, Trivedi, JK, additional, and Tekkalaki, Bheemsain, additional
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- 2014
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8. Reply to Indian contribution to the cultural formulation interview and the DSM-5: Missing details from the position paper
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Jacob, KS, primary, Kallivayalil, RA, additional, Mallik, AK, additional, Gupta, N, additional, Trivedi, JK, additional, Gangadhar, BN, additional, Praveenlal, K, additional, Vahia, V, additional, and Rao, T.SSathyanarayana, additional
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- 2013
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9. Prescription pattern of mood stabilizers for bipolar disorder at a tertiary health care centre in north India
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Trivedi, JK, primary, Sareen, Himanshu, additional, Rai, ShyamBihari, additional, and Yadav, VirendraSingh, additional
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- 2013
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10. Diagnostic and statistical manual‑5: Position paper of the Indian psychiatric society
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Jacob, KS, primary, Kallivayalil, RA, additional, Mallik, AK, additional, Gupta, N, additional, Trivedi, JK, additional, Gangadhar, BN, additional, Praveenlal, K, additional, Vahia, V, additional, and Sathyanarayana Rao, TS, additional
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- 2013
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11. Assessment of cognition in non-affected full biological siblings of patients with schizophrenia
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Dalal, PK, primary, Garg, Rohit, additional, Trivedi, JK, additional, Nischal, Anil, additional, Sinha, PK, additional, and Varma, Sannidhya, additional
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- 2013
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12. Suicide and antidepressants: What current evidence indicates
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Trivedi, JK, primary, Tripathi, Adarsh, additional, Nischal, Anil, additional, and Nischal, Anuradha, additional
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- 2012
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13. Pathway of psychiatric care
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Trivedi, JK, primary and Jilani, AbdulQadir, additional
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- 2011
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14. Anti-psychotic drug prescription pattern for schizophrenia: Observation from a general hospital psychiatry unit
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Trivedi, JK, primary, Dhyani, Mohan, additional, Yadav, VS, additional, and Rai, SB, additional
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- 2010
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15. Indian psychiatry, research and Asian countries
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Trivedi, JK, primary, Gupta, PawanKumar, additional, and Saha, Rahul, additional
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- 2010
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16. The Geriatric Population and Psychiatric Medication
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Varma, Sannidhya, primary, Sareen, Himanshu, additional, and Trivedi, JK, additional
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- 2010
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17. An overview of Indian research in anxiety disorders
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Trivedi, JK, primary and Gupta, PawanKumar, additional
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- 2010
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18. Psychological Aspects of Widowhood and Divorce
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Trivedi, JK, primary, Sareen, Himanshu, additional, and Dhyani, Mohan, additional
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- 2009
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19. Neurocognitive dysfunction in patients with obsessive compulsive disorder
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Trivedi, JK, primary, Dhyani, M, additional, Goel, D, additional, Sharma, S, additional, Singh, AP, additional, Sinha, PK, additional, and Tandon, RA, additional
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- 2008
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20. Undergraduate psychiatric education in South Asian countries
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Trivedi, JK, primary and Dhyani, Mohan, additional
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- 2007
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21. What psychiatry means to us
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Trivedi, JK, primary and Goel, Dishanter, additional
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- 2006
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22. Cognitive deficits in psychiatric disorders: Current status
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Trivedi, JK, primary
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- 2006
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23. Prescribing patterns of low doses of antipsychotic medications in older Asian patients with schizophrenia, 2001-2009.
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Xiang YT, Dickerson F, Kreyenbuhl J, Ungvari GS, Wang CY, Si TM, Lee EH, He YL, Chiu HF, Lai KY, Shinfuku N, Yang SY, Chong MY, Kua EH, Fujii S, Sim K, Yong MK, Trivedi JK, Chung EK, and Udomratn P
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Background: This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates.Methods: Information on hospitalized patients with schizophrenia, aged 55 years or older, was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (2001-2009). Data on 1,452 patients in eight Asian countries and territories including China, Hong Kong, Japan, Korea, Singapore, Taiwan, India, and Malaysia were analyzed. Sociodemographic and clinical characteristics and antipsychotic prescriptions were recorded using a standardized protocol and data collection procedure.Results: The prescription frequency for low doses of antipsychotic medications was 40.9% in the pooled sample. Multiple logistic regression analysis of the whole sample showed that patients on low doses of antipsychotic medications were more likely to be female, have an older age, a shorter length of illness, and less positive symptoms. Of patients in the six countries and territories that participated in all the surveys between 2001 and 2009, those in Japan were less likely to receive low doses of antipsychotics.Conclusion: Low doses of antipsychotic medications were only applied in less than half of older Asian patients with schizophrenia. [ABSTRACT FROM AUTHOR]- Published
- 2012
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24. Social factors and forensic psychiatry in India.
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Kallivayalil RA, Trivedi JK, and Tripathi A
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- 2009
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25. Rapid urbanization -- it's impact on mental health: a South Asian perspective.
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Trivedi JK, Sareen H, and Dhyani M
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- 2008
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26. 3H-spiperone binding in platelet membranes: a possible biological marker for schizophrenia
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Sethi Bb, A. K. Agarwal, P. Kumar, Trivedi Jk, and Prahlad K. Seth
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Adult ,Blood Platelets ,Male ,medicine.medical_specialty ,Spiperone ,Psychosis ,Adolescent ,medicine.medical_treatment ,Research Diagnostic Criteria ,Receptors, Dopamine ,Radioligand Assay ,Internal medicine ,Brief Psychiatric Rating Scale ,medicine ,Humans ,Platelet ,Antipsychotic ,Cell Membrane ,Middle Aged ,medicine.disease ,Butyrophenones ,Dissociation constant ,Psychiatry and Mental health ,Endocrinology ,Schizophrenia ,Female ,Psychology ,medicine.drug - Abstract
— High-affinity-specific IH-spiperone binding to platelet membranes was carried out in 30 schizophrenic patients, without prior antipsychotic medication, fulfilling the Research Diagnostic Criteria, and in 30 matched control subjects. The psychosis was rated on the Modified Brief Psychiatric Rating Scale. Compared with healthy subjects, schizophrenic patients had significantly higher 3H-spiperone binding due to a lower dissociation constant (38%), i.e. increased affinity. NO significant difference was observed in the maximum number of binding sites (Bmax) between the two groups. It is our contention that IH-spiperone binding to platelets may be a biological marker for schizophrenia.
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- 1986
27. Antianxiety effect of cannabis: involvement of central benzodiazepine receptors
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A. K. Agarwal, N. Sethi, Sethi Bb, P. Kumar, Anil Gulati, and Trivedi Jk
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Adult ,Flumazenil ,Male ,medicine.drug_class ,Population ,Poison control ,Mice, Inbred Strains ,Pharmacology ,Anxiety ,Tritium ,Mice ,Medicine ,Animals ,Humans ,Dronabinol ,Receptor ,education ,Biological Psychiatry ,Effects of cannabis ,Benzodiazepine ,education.field_of_study ,Benzodiazepinones ,Electroshock ,Diazepam ,biology ,business.industry ,GABAA receptor ,Cannabinoids ,Middle Aged ,biology.organism_classification ,Receptors, GABA-A ,Frontal Lobe ,Aggression ,Female ,Cannabis ,business ,medicine.drug - Abstract
The present work, involving clinical, behavioral, and biochemical studies, was undertaken to elucidate the probable mechanism of the observed antianxiety effects of cannabis. The population for the clinical study consisted of 50 male chronic cannabis users who were otherwise healthy and 50 matched controls. When evaluated on Taylor's Manifest Anxiety Scale (TMA), these subjects had low anxiety scores as compared with the controls. To explore the possible interaction of cannabis with the benzodiazepine receptors, behavioral and biochemical studies in mice were devised, involving acute and chronic cannabis administration. Behavioral study revealed that mice under chronic cannabis treatment scored significantly higher on foot shock-induced aggression, but this was significantly blocked by benzodiazepine receptor antagonist. Furthermore, chronic cannabis treatment significantly (p less than 0.001) increased the frequency of licking response periodically punished by shocks. This confirms the antianxiety effect of cannabis, which also appears to be mediated through a benzodiazepine receptor, as it was reduced significantly (p less than 0.001) by a benzodiazepine receptor blocker. Specific 3H-diazepam binding was carried out in frontal cortex to assess both the population and affinity of benzodiazepine receptors. Our results indicate that acute cannabis treatment has no significant effect, whereas chronic cannabis treatment significantly increased 3H-diazepam binding as compared with controls. Scatchard analysis further reveals that increased affinity is responsible for increased binding to these receptors. It is therefore our contention that the antianxiety effect of cannabis is mediated through central benzodiazepine receptors.
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- 1986
28. Ebstein's anomaly presenting with the acute coronary syndrome-a rare combination.
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Trivedi JK, Mahapatra RP, Gandham RK, Ramakrishna GV, Satapathy SK, Mohanty SK, and Suresh A
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Ebstein's anomaly is a relatively rare congenital heart disorder characterised by downward displacement of septal and posterior leaflets of the tricuspid valve into the right ventricle cavity. The usual presenting symptoms are cyanosis, right-sided heart failure and arrhythmia. Progressive heart failure or tachyarrhythmia may worsen cyanosis. The acute coronary syndrome is rarely reported in Ebstein's anomaly. We report a patient of undiagnosed Ebstein's anomaly who was apparently asymptomatic but presented with the acute coronary syndrome. This case report deals with a rare combination of congenital heart disease (Ebstein's anomaly) and coronary artery disease. Ebstein's anomaly (EA) has a prevalence of 1% of all congenital heart diseases, and little evidence is reported in the literature where EA along with coronary artery disease (CAD) exists in individuals less than 45 years old. Therefore, this case report brings attention to the rarity of those pathologies, which individually are already considered rare. And in this case, the association turns this diagnosis exceptional and highlights the complexity of the treatment., Competing Interests: Conflict of interestDr. Jaideep Kumar Trivedi is not a recipient of any research scholarship. The authors declare that they have no conflict of interest., (© Indian Association of Cardiovascular-Thoracic Surgeons 2019.)
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- 2020
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29. Intrapericardial dermoid cyst presenting with acute coronary syndrome.
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Trivedi JK, Raman Kumar GV, and Damodar Rao K
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- Acute Coronary Syndrome physiopathology, Adult, Coronary Artery Bypass methods, Coronary Disease diagnostic imaging, Coronary Disease etiology, Coronary Disease surgery, Dermoid Cyst diagnostic imaging, Dermoid Cyst surgery, Echocardiography, Transesophageal methods, Humans, Intraoperative Period, Male, Teratoma pathology, Treatment Outcome, Acute Coronary Syndrome etiology, Dermoid Cyst pathology, Mediastinal Cyst complications
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- 2019
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30. Metabolic syndrome and central obesity in depression: A cross-sectional study.
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Agarwal A, Agarwal M, Garg K, Dalal PK, Trivedi JK, and Srivastava JS
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Introduction: The current epidemiological data and meta-analyses indicate a bidirectional association between depression and metabolic syndrome (MetS)., Aims: To assess the prevalence of metabolic syndrome and obesity in drug naïve patients (in current episode) having Recurrent Major Depressive Disorder and Bipolar Depression., Method: This was a single point cross sectional observational study that involved administration of diagnostic and assessment tools and blood investigations. Recruitment for the study was done from a period of September 2008 to august 2009., Results: The prevalence of MetS was significantly more in the depression group when compared to healthy controls. The Bipolar depression group had 24% prevalence and recurrent depression group had 26% prevalence as opposed to none in the control group. The prevalence of MetS did not differ significantly amongst the both depression groups. Presence of central obesity was significantly more in the recurrent depression (30%) and Bipolar depression (24%) as compared to controls (8%). There was no statistically significant difference between the two depression subgroups., Discussion: Our study adds to the mounting evidence that links the presence of depression and metabolic syndrome. As we had ensured a drug free period of at least 3 months, the findings in our study indicate that the metabolic syndrome observed in our study is independent of drug exposure., Conclusions: This study demonstrated significantly more incidence of metabolic syndrome and central obesity in patients of depression than age and sex matched controls.
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- 2016
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31. Use of electroconvulsive therapy for Asian patients with schizophrenia (2001-2009): Trends and correlates.
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Xiang YT, Ungvari GS, Correll CU, Chiu HF, Lai KY, Wang CY, Si TM, Lee EH, He YL, Yang SY, Chong MY, Kua EH, Fujii S, Sim K, Yong MK, Trivedi JK, Chung EK, Udomratn P, Chee KY, Sartorius N, Tan CH, and Shinfuku N
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- Adult, Antipsychotic Agents therapeutic use, Asia, Combined Modality Therapy trends, Female, Humans, Male, Middle Aged, Schizophrenia drug therapy, Asian People statistics & numerical data, Electroconvulsive Therapy statistics & numerical data, Electroconvulsive Therapy trends, Inpatients statistics & numerical data, Practice Patterns, Physicians' statistics & numerical data, Schizophrenia therapy
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Aims: Little is known about electroconvulsive therapy (ECT) use in Asian inpatients with schizophrenia. This study examined trends of ECT use for schizophrenia patients in Asia between 2001 and 2009 and its independent demographic and clinical correlates., Methods: Data on 6761 hospitalized schizophrenia patients (2001 = 2399, 2004 = 2136, and 2009 = 2226) in nine Asian countries and territories were collected by either chart review or interviews during a 1-month period. Patients' sociodemographic and clinical characteristics, prescriptions of psychotropic drugs and ECT use were recorded using a standardized protocol and data-collection procedure., Results: The frequency of ECT was 3.3% in the whole sample; rising from 1.8% in 2001 to 3.3% in 2004 and 4.9% in 2009 (P < 0.0001). However, this increased trend was driven solely by increased ECT use in China (P < 0.0001), and the inclusion of India in the 2009 survey. There were wide inter-country variations: 2001, 0% (Hong Kong, Korea) to 5.9% (China); 2004, 0% (Singapore) to 11.1% (China); 2009, 0% (Hong Kong) to 13.8% (India) and 15.2% (China). Multiple logistic regression analysis of the whole sample revealed that patients receiving ECT were less likely in the 35-64-year age group, had shorter length of current hospitalization and fewer negative symptoms, and were more likely to receive second-generation antipsychotic medications compared to those who were not treated with ECT (R(2) = 0.264, P < 0.001)., Conclusions: ECT use for schizophrenia has increased over the past decade in China, being low/relatively stable in other Asian countries/regions. Reasons for substantial variations in ECT frequency in Asia require further study., (© 2015 The Authors. Psychiatry and Clinical Neurosciences © 2015 Japanese Society of Psychiatry and Neurology.)
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- 2015
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32. Prevalence and prescription of antidepressants in depression with somatic comorbidity in Asia: the Research on East Asian Psychotropic Prescription Patterns study.
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Chen C, Si TM, Xiang YT, Ungvari GS, Wang CY, He YL, Kua EH, Fujii S, Sim K, Trivedi JK, Chung EK, Udomratn P, Chee KY, Sartorius N, Tan CH, and Shinfuku N
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- Adult, Asia, Asian People, Female, Humans, Male, Middle Aged, Prevalence, Antidepressive Agents therapeutic use, Depression drug therapy, Depression epidemiology, Drug Prescriptions statistics & numerical data
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Background: Depression is often comorbid with chronic somatic diseases. Few previous studies have investigated the prevalence of somatic diseases in depression or the prescription pattern of antidepressants in comorbidly depressed patients in Asia. This study aimed to investigate the prevalence of somatic comorbidity (SC) in depression and compared the prescriptions of antidepressants in depressed patients with and without SC., Methods: A total of 2320 patients treated with antidepressants in 8 Asian countries were examined, and a diagnosis was based on the International Classification of Disease, 10 th revision. We listed 17 common chronic somatic diseases. Patients' socio-demographic and clinical characteristics and psychotropic drug prescriptions were recorded using a standardized protocol and data collection procedure., Results: Of the patients examined, 1240 were diagnosed with depression and 30% of them (n = 375) had SC. The most common comorbid condition was diabetes (23.7%). The patients with SC were more likely to seek help at a general hospital (74.7% vs. 47.2%), and had a higher incidence of symptoms involving sadness, disturbed sleep, and poor appetite. Noradrenergic and specific serotonergic antidepressant was prescribed more for patients with SC than for those without SC (30.4% vs. 22.9%)., Conclusions: SC is common in depressed Asian patients. It is important to strengthen the recognition of depression, especially in general hospitals and when patients report some somatic discomfort. It is also a matter of urgency to establish evidence-based guidelines for the use of new antidepressants in depressed patients with SC.
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- 2015
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33. QTc prolongation in schizophrenia patients in Asia: clinical correlates and trends between 2004 and 2008/2009.
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Xiang YT, Chiu HF, Ungvari GS, Correll CU, Lai KY, Wang CY, Si TM, Lee EH, He YL, Yang SY, Chong MY, Kua EH, Fujii S, Sim K, Yong MK, Trivedi JK, Chung EK, Udomratn P, Chee KY, Sartorius N, Tan CH, and Shinfuku N
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- Adult, Aged, Antipsychotic Agents adverse effects, Asia epidemiology, Electrocardiography, Female, Health Surveys, Hospitalization statistics & numerical data, Hospitalization trends, Humans, International Cooperation, Logistic Models, Long QT Syndrome chemically induced, Long QT Syndrome diagnosis, Male, Middle Aged, Retrospective Studies, Schizophrenia drug therapy, Long QT Syndrome epidemiology, Schizophrenia epidemiology
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Objective: Little is known about the pattern of QT interval (QTc) prolongation in Asian patients with schizophrenia. This study examined trends of QTc prolongation in schizophrenia inpatients in six Asian countries and territories between 2004 and 2008/2009 and its independent demographic and clinical correlates., Method: Data on 3482 hospitalized schizophrenia patients (2004 = 1826 and 2008/2009 = 1656) in six Asian countries and territories were collected by either chart review or interviews during a 1-month period. Patients' sociodemographic and clinical characteristics, prescriptions of psychotropic drugs, and QTc interval were recorded using a standardized protocol and data collection procedure., Results: The frequency of QTc prolongation (>456 ms) was 2.4% in the whole sample, decreasing from 3.1% in 2004 to 1.6% in 2008/2009 (p = 0.004) with wide intercountry variations. However, this decreased trend was driven by decreased QTc prolongation detected in China and Hong Kong (both p-values < 0.05). Multiple logistic regression analysis of the whole sample revealed that patients having more likely to have an illness lasting longer than 5 years and received antipsychotics classified as list-1 drugs according to the Arizona Centre for Education and Research on Therapeutics. Compared with 2004, patients in 2008/2009 were less likely to have QTc prolongation. Thioridazine caused QTc prolongation most frequently (odds ratio (OR) 4.4; 95% confidence interval (CI) 1.2-15.2), followed by sulpiride (OR 2.4; 95% CI 1.3-4.5), clozapine (OR 2.4; 95% CI 1.4-4.2), and chlorpromazine (OR 1.9; 95% CI 1.07-3.5)., Conclusions: Frequency of QTc prolongation was low in Asian patients with schizophrenia. QTc prolongation in schizophrenia decreased in China and Hong Kong between 2004 and 2008/2009 but increased in Taiwan over the same period, remaining low in the other countries., (Copyright © 2015 John Wiley & Sons, Ltd.)
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- 2015
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34. The reliability and validity of the MATRICS functional assessment battery.
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Velligan DI, Fredrick M, Mintz J, Li X, Rubin M, Dube S, Deshpande SN, Trivedi JK, Gautam S, Avasthi A, Kern RS, and Marder SR
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- Adult, Clinical Trials as Topic, Female, Humans, Male, Reproducibility of Results, Outcome Assessment, Health Care standards, Psychiatric Status Rating Scales standards, Psychometrics instrumentation, Schizophrenia diagnosis
- Abstract
Objectives: The Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative was designed to encourage the development of cognitive enhancing agents for schizophrenia. For a medication to receive this indication, regulatory agencies require evidence of improvement in both cognition and functional outcome. Functional capacity measures typically used in clinical trials as intermediate measures of functional outcome must be adapted to fit different cultural contexts for use internationally. We examined the psychometric properties of the MATRICS Functional Assessment Battery (MFAB), comprised of 2 subtests from the UCSD Performance-based Skills Assessment (UPSA) and one from the Test of Adaptive Behavior in Schizophrenia (TABS) that were rated by experts in a previous study to be the most appropriate functional capacity assessments across different cultural contexts., Method: Four sites in India administered the MFAB, a brief version of the UPSA, the MATRICS Cognitive Consensus Battery, measures of symptomatology, and a measure of global functional outcome to 141 individuals with schizophrenia at a baseline assessment and at 4 weeks later., Results: Test-retest reliability based on the intraclass correlation coefficient was significantly better for the UCSD Performance-Based Skills Assessment-Brief (UPSA-B). Pearson correlation coefficients over time were not significantly different for the 2 measures. Only the MFAB was significantly correlated with functional outcome as measured by the Specific Levels of Functioning Scale., Conclusions: The psychometric properties of the MFAB and UPSA-B were similar. The MATRICS scientific board chose to translate the MFAB into multiple languages for potential use in studies of novel medications seeking an indication for improving cognition in schizophrenia., (© The Author 2013. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2014
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35. Preventive psychiatry: Concept appraisal and future directions.
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Trivedi JK, Tripathi A, Dhanasekaran S, and Moussaoui D
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- Evidence-Based Medicine, Humans, Psychiatry trends, Concept Formation, Mental Disorders prevention & control, Psychiatry methods
- Abstract
Preventive psychiatry is a branch of psychiatry that aims at health promotion, protection from specific mental illnesses, early diagnosis, effective treatment, disability limitation and rehabilitation. Prevention of neuropsychiatric illnesses as compared to other illnesses is particularly important as they run a chronic course and cause substantial disability. Preventive measures have been found to be effective in reducing incidence and disability in a wide range of mental illnesses such as depression, psychosis, anxiety and conduct disorders. The need of the hour is to translate advances in our understanding of mental illness into effective intervention programmes for the prevention of mental illness and the promotion of positive mental health., (© The Author(s) 2013.)
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- 2014
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36. Electroconvulsive therapy pre-treatment with low dose propofol: comparison with unmodified treatment.
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Tripathi A, Winek NC, Goel K, D'Agati D, Gallegos J, Jayaram G, Nguyen T, Vaidya P, Zandi P, Trivedi JK, and Reti IM
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- Adolescent, Adult, Aged, Cognition drug effects, Cognition physiology, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Young Adult, Anesthetics, Intravenous administration & dosage, Electroconvulsive Therapy methods, Propofol administration & dosage, Psychotic Disorders therapy
- Abstract
Background: Whilst electroconvulsive therapy (ECT) is routinely administered under anesthesia in developed nations, in many developing countries, ECT is still administered unmodified. This practice has attracted considerable scrutiny with calls to ban unmodified ECT. However, there are no affordable alternatives for many poor, acutely ill psychiatric patients. We evaluated whether administration of intravenous propofol 0.5 mg/kg for sedation by the ECT psychiatrist just prior to otherwise unmodified treatment improved acceptance of and reduced anxiety surrounding the treatment., Method: We conducted an open label trial at The King George's Medical University in Lucknow, India. Forty-nine patients received propofol pre-treatment and 50 patients received unmodified treatment as usual., Results: Socio-demographic profiles, diagnoses and clinical responses were comparable. Patients who received propofol experienced less anxiety monitored by the State-Trait Anxiety Inventory just prior to ECT (p < 0.001), and had a more favorable attitude towards treatment assessed by an established questionnaire (Freeman and Kendell, 1980). Propofol patients were less likely to experience post-ictal delirium monitored by the CAM-ICU (p = 0.015) and had fewer cognitive side-effects on the MMSE (p = 0.004). There were no adverse events associated with propofol administration., Conclusion: Whilst unmodified ECT should never be used when modified ECT under anesthesia is available, we have found low dose propofol can be safely administered by the ECT psychiatrist to sedate patients pre-treatment who would otherwise receive completely unmodified treatment. The intervention was associated with reduced anxiety and a more positive attitude towards ECT, without compromising efficacy. A randomized double blind controlled study is necessary to confirm these benefits., (Copyright © 2014 Elsevier Ltd. All rights reserved.)
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- 2014
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37. Common use of high doses of antipsychotic medications in older Asian patients with schizophrenia (2001-2009).
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Xiang YT, Li Y, Correll CU, Ungvari GS, Chiu HF, Lai KY, Tang QS, Hao W, Si TM, Wang CY, Lee EH, He YL, Yang SY, Chong MY, Kua EH, Fujii S, Sim K, Yong MK, Trivedi JK, Chung EK, Udomratn P, Chee KY, Sartorius N, Tan CH, and Shinfuku N
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- Age Distribution, Aged, Aged, 80 and over, Female, Humans, Logistic Models, Male, Middle Aged, Practice Patterns, Physicians' statistics & numerical data, Schizophrenia ethnology, Socioeconomic Factors, Antipsychotic Agents administration & dosage, Asian People, Schizophrenia drug therapy
- Abstract
Objective: This study aimed to examine the use of high doses of antipsychotic medications (≥600 mg/day chlorpromazine equivalent) in older Asian patients with schizophrenia and its demographic and clinical correlates., Method: Information on hospitalized patients with schizophrenia aged ≥50 years was extracted from the database of the Research on Asian Psychotropic Prescription Patterns study (2001-2009). Data on 2203 patients in six Asian countries and territories, including China, Hong Kong, Japan, Korea, Singapore and Taiwan, were analyzed. Socio-demographic and clinical characteristics and antipsychotic prescriptions were recorded., Results: The frequency for high-dose antipsychotic medications was 36.0% overall, with 38.4% in 2001, 33.3% in 2004 and 36.0% in 2009. Multiple logistic regression analysis of the whole sample showed that compared to patients receiving low-medium antipsychotic doses, those on high doses had a longer illness duration (odds ratio (OR): 2.0, 95% confidence interval (CI):1.2-3.3, p = 0.008), were more likely in the 50-59-year group (OR: 0.95, 95% CI: 0.94-0.97, p < 0.001), more often had current positive (OR: 1.5, 95% CI: 1.2-1.8, p < 0.001) or negative symptoms (OR: 1.3, 95% CI: 1.03-1.6, p = 0.03), and more commonly received antipsychotic polypharmacy (OR: 5.3, 95% CI: 4.1-6.7, p < 0.001). Extrapyramidal symptoms (p = 0.25) and tardive dyskinesia (p = 0.92) were not more frequent in the high-dose group., Conclusions: High doses of antipsychotic medications were used in more than one third of older Asian patients with schizophrenia. The reasons for the frequent use of high antipsychotic doses in older Asian patients warrant further investigation., (Copyright © 2013 John Wiley & Sons, Ltd.)
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- 2014
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38. Welcome biological breakthroughs, supply psychosocial insights.
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Tekkalaki B, Tripathi A, and Trivedi JK
- Abstract
Human behaviour, emotions, and cognition are complex to understand and explain. It is even more difficult to understand the basis for abnormal behaviour, disturbed emotions, and impaired cognitions, something mental health professionals are trying for long. In these pursuits, psychiatry has traversed through eras of humours, witchcraft, spirits, psychoanalysis, and gradually deviated from other medical specialities. Now, with recent biological breakthroughs like advances in psychopharmacology, neuroimaging and genetics, increasingly more emphasis is being given to the biological model of psychiatric disorders. These new biological models have given a more scientific appearance to the speciality. It has also revolutionised the management strategies and outcome of many psychiatric disorders. However, this rapid development in biological understanding of psychiatry also leads to a new wave of reductionism. In an attempt to deduce everything in terms of neurons, neurochemicals, and genes, can we neglect psychosocial aspects of mental health? Patients' personality, expectations, motives, family background, sociocultural backgrounds continue to affect mental health no matter how much 'biological' psychiatry gets. Biological and psychosocial approaches are not mutually exclusive but complementary. Integrating them harmoniously is the skill psychiatry demands for comprehensive understanding of mental and behavioural disorders.
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- 2014
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39. Assessment of cognition in non-affected full biological siblings of patients with schizophrenia.
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Garg R, Trivedi JK, Dalal PK, Nischal A, Sinha PK, and Varma S
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Background: Schizophrenia is a devastating psychotic illness which is like the most mental disorders, shows complex inheritance; the transmission of the disorder most likely involves several genes and environmental factors. It is difficult to judge whether a particular person without schizophrenia has predisposing factors for the said disease. A few studies have shown the relative sensitivity and reliability of cognitive and psychophysiological markers of brain function as the susceptibility factors for schizophrenia which may aid us to find people with an increased risk of complex disorders like schizophrenia. The present work is an exploration on cognitive impairments in unaffected siblings of patients suffering from schizophrenia with a framework to explore why a mental disorder occurs in some families but not in others., Materials and Methods: This is a single point non-invasive study of non-affected full biological siblings of patients with schizophrenia, involving administration of a battery of neuropsychological tests to assess the cognitive function in the sibling group and a control group of volunteers with no history of psychiatric illness. The control group was matched for age, gender, and education. The siblings were also divided on the basis of the type of schizophrenia their siblings (index probands) were suffering from and their results compared with each other., Results: The siblings performed significantly poorly as compared to the controls on Wisconsin card sorting test (WCST), continuous performance test (CPT), and spatial working memory test (SWMT). The comparison between the sibling subgroups based on the type of schizophrenia in the index probands did not reveal any significant difference., Conclusion: These findings suggest that there is a global impairment in the cognition of the non-affected siblings of patients of schizophrenia. Cognitive impairment might be one of the factors which will help us to hit upon people who are predisposed to develop schizophrenia in the future.
- Published
- 2013
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40. Sociodemographic and clinical profile of homeless mentally ill inpatients in a north Indian medical university.
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Tripathi A, Nischal A, Dalal PK, Agarwal V, Agarwal M, Trivedi JK, Gupta B, and Arya A
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- Adult, Female, Ill-Housed Persons statistics & numerical data, Hospitalization statistics & numerical data, Humans, India epidemiology, Male, Residence Characteristics statistics & numerical data, Retrospective Studies, Rural Health statistics & numerical data, Socioeconomic Factors, Urban Health statistics & numerical data, Ill-Housed Persons psychology, Mental Disorders epidemiology
- Abstract
Homeless mentally ill (HMI) persons are a highly vulnerable and socially disadvantaged population, deprived of even the basic minimal human rights. Data on HMI in India is scarce. This retrospective chart review aimed to evaluate socio-demographic, socio-cultural and clinical profile of HMI patients, and to study reasons of homelessness and outcome related variables in these patients. One hundred and forty homeless persons were admitted to the department of psychiatry of a north Indian medical university from February 2005 to July 2011. Of these, one hundred and twenty-seven (90.7%) had psychiatric illness and six had only intellectual disabilities. The majority of HMI persons were illiterate/minimally literate, adult, male, and from low socioeconomic and rural backgrounds. Most of the patients (55.7%) had more than one psychiatric diagnosis. HMI had considerably high rates of co-morbid substance abuse (44.3%), intellectual disabilities (38.6%) and physical problems (75.4%). Most (84.3%) were mentally ill before leaving home and 54.3% left home themselves due to the illness. Most HMI responded to the treatment. After treatment of mental illness, it was possible to reintegrate about 70% of the patients into their families. Families were willing to accept and support them. Untreated/inadequately treated mental illness was the most common reason for homelessness. Easily accessible treatment and rehabilitation facilities at low cost can improve the plight of such patients. Further research in this area is required., (Copyright © 2013 Elsevier B.V. All rights reserved.)
- Published
- 2013
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41. Child psychopharmacology: Is it more similar than different from adult psychopharmacology?
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Sareen H and Trivedi JK
- Abstract
Despite having a large chunk of human population, Asian countries face shortage of mental health professionals. There is further shortage of doctors dealing with special groups of population like the children, the elderly, and the medically ill. However, in this era of super-specializations, are the basic principles of general psychopharmacology being forgotten? Dealing with child population is different and often more difficult than adult population but are management guidelines for the two populations vastly divergent? A close look at this paints a different picture. Psychotherapies applied in adults and those in children and adolescents are disparate owing to cognitive, social, emotional, and physical immaturation in children and adolescents. But the drugs for the treatment of pediatric psychiatric disorders are mostly similar to those prescribed for adults (case in point -bipolar disorders, obsessive compulsive disorder, schizophrenia). Rather than focusing energy on propagating the differences in assorted subgroups of population, honing of skills regarding intricacies of psychopharmacology is required to be emphasized. Detailed history taking, careful evaluation of the patient, sound diagnostic formulation, and prescribing medications which are tailor made to the patient will all go a long way in ensuring a functional recovery of the patients irrespective of the group they belong to.
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- 2013
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42. Use of clozapine in older Asian patients with schizophrenia between 2001 and 2009.
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Xiang YT, Buchanan RW, Ungvari GS, Chiu HF, Lai KY, Li YH, Si TM, Wang CY, Lee EH, He YL, Yang SY, Chong MY, Kua EH, Fujii S, Sim K, Yong MK, Trivedi JK, Chung EK, Udomratn P, Chee KY, Sartorius N, Tan CH, and Shinfuku N
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- Adult, Aged, Asia epidemiology, Female, Health Surveys, Humans, Male, Middle Aged, Schizophrenia epidemiology, Time Factors, Young Adult, Antipsychotic Agents therapeutic use, Clozapine therapeutic use, Practice Patterns, Physicians', Schizophrenia drug therapy
- Abstract
Background: To date there has been no large-scale international study that examined the use of clozapine in older patients with schizophrenia. This study examined the use of clozapine and its demographic and clinical correlates in older patients with schizophrenia in East Asia during the period between 2001 and 2009., Method: Information on 1,157 hospitalized patients with schizophrenia aged 50 or older in five East Asian countries and territories (China, Hong Kong, Korea, Singapore and Taiwan) was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) project. Socio-demographic and clinical characteristics and prescription of psychotropic medications were recorded., Results: Clozapine was prescribed for 20.6% of the pooled sample; 19.0% in 2001, 19.4% in 2004 and 22.9% in 2009. Multiple logistic regression analysis of the whole sample revealed that patients taking clozapine had a longer duration of illness, more negative symptoms and were less likely to receive first generation antipsychotic and anticholinergic drugs, but more likely to report weight gain compared to those not receiving clozapine. Compared to those in other sites, older patients in China were more likely to receive clozapine., Conclusions: The prescription of clozapine for older Asian schizophrenia inpatients has remained at a stable level during the past decade. The appropriateness of use of clozapine in China needs to be further explored.
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- 2013
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43. Adjunctive antidepressant prescriptions for hospitalized patients with schizophrenia in Asia (2001-2009).
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Xiang YT, Ungvari GS, Wang CY, Si TM, Lee EH, Chiu HF, Lai KY, He YL, Yang SY, Chong MY, Tan CH, Kua EH, Fujii S, Sim K, Yong MK, Trivedi JK, Chung EK, Udomratn P, Chee KY, Sartorius N, and Shinfuku N
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- Adult, Asia epidemiology, Chemotherapy, Adjuvant statistics & numerical data, Female, Hospitalization statistics & numerical data, Humans, Longitudinal Studies, Male, Practice Patterns, Physicians' statistics & numerical data, Schizophrenia epidemiology, Antidepressive Agents therapeutic use, Drug Prescriptions statistics & numerical data, Schizophrenia drug therapy
- Abstract
Introduction: Little is known about the prescription patterns of adjunctive antidepressants in Asian schizophrenia patients. This study aimed to examine trends in the use of antidepressants and their demographic and clinical correlates in the treatment of schizophrenia in Asia between 2001 and 2009., Methods: A total of 6,761 hospitalized schizophrenia patients in nine Asian countries and territories were examined: 2,399 in 2001, 2,136 in 2004 and 2,226 in 2009. Patients' socio-demographic and clinical characteristics and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure., Results: The proportion of antidepressant prescription was 6.8% in the whole sample; 5.3% in 2001, 6.5% in 2004 and 8.7% in 2009. There were wide inter-country variations at each survey ranging from 0.9% in Hong Kong to 15.3% in Singapore in 2001; from 1.9% in Korea to 15.4% in Singapore in 2004; and from 2.7% in Japan to 22.0% in Singapore in 2009. Multiple logistic regression analysis of the whole sample revealed that patients on antidepressants were younger, more likely to receive benzodiazepines and have significant extrapyramidal side-effects and less likely to have significant positive symptoms., Discussion: Unlike findings in Western countries, adjunctive antidepressant prescription for schizophrenia was not common in Asia. The frequency of antidepressant prescription varied among countries and territories, suggesting that a host of clinical and socio-cultural factors played a role in determining antidepressant use in Asia., (Copyright © 2012 Wiley Publishing Asia Pty Ltd.)
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- 2013
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44. Suicidal behaviour of Indian patients with obsessive compulsive disorder.
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Dhyani M, Trivedi JK, Nischal A, Sinha PK, and Verma S
- Abstract
Background Setting and Design: The chronicity, distress, high rates of comorbidity and varying degree of non response to treatment in Obsessive Compulsive Disorder (OCD) may contribute to suicidal behavior. There is relatively little information on suicidal behavior in OCD subjects. Our study design is Single point non-invasive, cross sectional, clinical study of new and follow up cases., Materials and Methods: Assessment of Suicidal Behavior in patients of OCD attending the adult Psychiatry O.P.D. of Chatrapati Shahuji Maharaj Medical University (CSMMU) U.P. Lucknow using (DSM-IV) criteria for diagnosis of Obsessive Compulsive Disorder, Structured Clinical Interview for DSM-IV Axis-I disorders, Yale Brown Obsessive Compulsive Rating Scale, Scale for Suicidal Ideation (SSI), Beck's Hopelessness Scale (BHS)., Statistical Analysis: Mean standard deviation and t test for independent samples, Pearson's correlation coefficient., Results: Statistically significant differences were seen in the SSI score between the "Clinical" and "Sub-Clinical" cases with Clinical group having higher scores. Value of correlation coefficient between YBOCS score and SSI and BHS score is positive and statistically significant (P<0.01)., Conclusion: "Clinical" group of patients had significantly higher scores of suicidal ideation measured by Scale of Suicidal Ideation (SSI). There was a significantly positive correlation between disease severity (YBOCS Score) and degree of suicidal ideation (SIS Score).
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- 2013
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45. Association of psychiatric co-morbidity and efficacy of treatment in chronic daily headache in Indian population.
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Singh AK, Shukla R, Trivedi JK, and Singh D
- Abstract
Objective: To study the prevalence of psychiatric co-morbidity in patients of chronic daily headache (CDH) and compare the efficacy of treatment between various type of headache associated with psychiatric co-morbidity., Materials and Methods: Prospective case control cohort study, 92 consecutive patients of CDH meeting eligibility criteria. The diagnosis of various subtypes of CDH was made according to the IHS criteria. Age, sex, educational, marital and socioeconomic status, matched controls were also selected. Patients were evaluated with the Mini International Neuropsychiatric Interview (MINI) scale at the time of enrolment and at 3 months., Results: CDH accounted for 28% of all headache patients. The mean age of presentation was 30.2 ± 10.3 years, male: Female ratio of 28:64 and mean duration of 4.56 ± 0.56 years. Chronic migraine (CM) accounted for 59 patients, chronic tension type headache (CTTH) 22 patients, new daily persistent headache (NDPH) 3 patients and miscellaneous 8 patients. Psychiatric co-morbidity was present in 53.3% patients with CDH, and was more common in CM (62.7%) as compared to CTTH (36.4%). Single psychiatric co-morbidity was seen in 26 patients, while 23 patients had multiple co-morbidity. Major depressive episode, anxiety disorder, agoraphobia and dysthymia were significant psychiatric co-morbidities. Patients with CM were treated with topiramate or divalproex sodium ER and CTTH were treated with amitriptyline. 55 patients came for follow up at 3 months, improvement in headache was seen in 29 patients., Conclusion: Psychiatric co-morbidity was present in more than 50% patients with CDH and its presence along with a duration of ≥2 years was associated with a poor response to treatment.
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- 2013
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46. Cross-national differences in the prevalence and correlates of burden among older family caregivers in the World Health Organization World Mental Health (WMH) Surveys.
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Shahly V, Chatterji S, Gruber MJ, Al-Hamzawi A, Alonso J, Andrade LH, Angermeyer MC, Bruffaerts R, Bunting B, Caldas-de-Almeida JM, de Girolamo G, de Jonge P, Florescu S, Gureje O, Haro JM, Hinkov HR, Hu C, Karam EG, Lépine JP, Levinson D, Medina-Mora ME, Posada-Villa J, Sampson NA, Trivedi JK, Viana MC, and Kessler RC
- Subjects
- Adult, Age Factors, Caregivers economics, Caregivers trends, Child, Chronic Disease economics, Chronic Disease nursing, Epidemiologic Methods, Family, Family Health economics, Female, Global Health, Home Nursing economics, Home Nursing trends, Humans, Male, Mental Disorders economics, Mental Disorders nursing, Middle Aged, Socioeconomic Factors, Time Factors, World Health Organization, Caregivers statistics & numerical data, Cost of Illness, Cross-Cultural Comparison, Family Health statistics & numerical data, Home Nursing statistics & numerical data, Population Dynamics trends
- Abstract
Background: Current trends in population aging affect both recipients and providers of informal family caregiving, as the pool of family caregivers is shrinking while demand is increasing. Epidemiological research has not yet examined the implications of these trends for burdens experienced by aging family caregivers. Method Cross-sectional community surveys in 20 countries asked 13 892 respondents aged 50+ years about the objective (time, financial) and subjective (distress, embarrassment) burdens they experience in providing care to first-degree relatives with 12 broadly defined serious physical and mental conditions. Differential burden was examined by country income category, kinship status and type of condition., Results: Among the 26.9-42.5% respondents in high-, upper-middle-, and low-/lower-middle-income countries reporting serious relative health conditions, 35.7-42.5% reported burden. Of those, 25.2-29.0% spent time and 13.5-19.4% money, while 24.4-30.6% felt distress and 6.4-21.7% embarrassment. Mean caregiving hours per week in those giving any time were 16.6-23.6 (169.9-205.8 h/week per 100 people aged 50+ years). Burden in low-/lower-middle-income countries was 2- to 3-fold higher than in higher-income countries, with any financial burden averaging 14.3% of median family income in high-, 17.7% in upper-middle-, and 39.8% in low-/lower-middle-income countries. Higher burden was reported by women than men and for conditions of spouses and children than parents or siblings., Conclusions: Uncompensated family caregiving is an important societal asset that offsets rising formal healthcare costs. However, the substantial burdens experienced by aging caregivers across multiple family health conditions and geographic regions threaten the continued integrity of their caregiving capacity. Initiatives supporting older family caregivers are consequently needed, especially in low-/lower-middle-income countries.
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- 2013
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47. Electroconvulsive treatment in catatonia of cerebrovasculo-coagulopathy: a case report.
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Kar SK, Saxena S, and Trivedi JK
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- Adult, Antipsychotic Agents therapeutic use, Depression, Postpartum psychology, Female, GABA Modulators therapeutic use, Humans, Lorazepam therapeutic use, Nervous System Diseases etiology, Nervous System Diseases psychology, Risperidone therapeutic use, Catatonia etiology, Catatonia therapy, Cerebrovascular Disorders complications, Cerebrovascular Disorders therapy, Depression, Postpartum therapy, Electroconvulsive Therapy, Thrombosis complications, Thrombosis therapy
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- 2013
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48. Common use of anticholinergic medications in older patients with schizophrenia: findings of the Research on Asian Psychotropic Prescription Pattern (REAP) study, 2001-2009.
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Xiang YT, Dickerson F, Kreyenbuhl J, Ungvari GS, Wang CY, Si TM, Lee EH, Chiu HF, Lai KY, He YL, Yang SY, Chong MY, Tan CH, Kua EH, Fujii S, Sim K, Yong MK, Trivedi JK, Chung EK, Udomratn P, Chee KY, Sartorius N, and Shinfuku N
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- Aged, Asia, Cross-Sectional Studies, Female, Humans, Logistic Models, Male, Middle Aged, Cholinergic Antagonists therapeutic use, Drug Prescriptions statistics & numerical data, Schizophrenia drug therapy
- Abstract
Objective: This study surveyed the use of anticholinergic medications (ACMs) in older Asian patients with schizophrenia and examined its demographic and clinical correlates., Method: A total of 1452 hospitalized patients with schizophrenia aged 55 years or older in nine Asian countries and territories were surveyed between 2001 and 2009. The cross-sectional data of patients' socio-demographic and clinical characteristics and the prescriptions of antipsychotic drugs and ACM were recorded using a standardized protocol and data collection procedure., Results: The frequency of ACM prescription was 64.6% in the pooled sample, with 72.4%, 61.9%, and 59.5% in 2001, 2004, and 2009, respectively. Multiple logistic regression analysis of the whole sample revealed that patients on ACM had a higher dose of antipsychotic medications, and were more likely to have extrapyramidal side effects and receive first-generation antipsychotic medications., Conclusions: Anticholinergic medications were frequently used in older Asian patients with schizophrenia. Considering the potential side effects of ACM, the rationale for their widespread use in this patient population should be revisited., (Copyright © 2012 John Wiley & Sons, Ltd.)
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- 2013
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49. Common use of antipsychotic polypharmacy in older Asian patients with schizophrenia (2001-2009).
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Xiang YT, Dickerson F, Kreyenbuhl J, Ungvari GS, Wang CY, Si TM, Lee EH, He YL, Chiu HF, Yang SY, Chong MY, Tan CH, Kua EH, Fujii S, Sim K, Yong MK, Trivedi JK, Chung EK, Udomratn P, Chee KY, Sartorius N, and Shinfuku N
- Subjects
- Aged, Antipsychotic Agents adverse effects, Databases, Factual trends, Female, Hospitalization trends, Humans, Male, Middle Aged, Outcome Assessment, Health Care trends, Antipsychotic Agents administration & dosage, Asian People ethnology, Polypharmacy, Schizophrenia drug therapy, Schizophrenia ethnology
- Abstract
Objective: The aim of this study was to survey the use of antipsychotic polypharmacy (APP) in older Asian patients with schizophrenia and examine its demographic and clinical correlates., Methods: Information on hospitalized patients with schizophrenia aged 55 or older was extracted from the database of the Research on Asian Psychotropic Prescription Patterns study. Data on 1439 patients in 6 Asian countries and territories including China, Hong Kong, Japan, Korea, Singapore, and Taiwan were analyzed. Sociodemographic and clinical characteristics and antipsychotic prescriptions were recorded using a standardized protocol and data collection procedure., Results: The frequency of APP prescription was 51.6% in the pooled sample with wide intercountry variations. Multiple logistic regression analysis of the whole sample showed that patients on APP had higher antipsychotic doses and also were more likely to receive first-generation antipsychotics., Conclusions: Use of APP was common in older Asian patients with schizophrenia. Given the limited evidence supporting its efficacy, the potentially severe side effects and high costs, APP should be used with caution in this population. The reasons for and outcomes of the use of APP in this patient population merit further exploration.
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- 2012
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50. Use of first- and second-generation antipsychotic medications in older patients with schizophrenia in Asia (2001-2009).
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Xiang YT, Kreyenbuhl J, Dickerson FB, Ungvari GS, Wang CY, Si TM, Lee EH, He YL, Chiu HF, Yang SY, Chong MY, Tan CH, Kua EH, Fujii S, Sim K, Yong MK, Trivedi JK, Chung EK, Udomratn P, Chee KY, Sartorius N, and Shinfuku N
- Subjects
- Aged, Asia epidemiology, Cross-Sectional Studies, Demography, Dose-Response Relationship, Drug, Female, Health Impact Assessment, Health Knowledge, Attitudes, Practice, Hospitalization statistics & numerical data, Humans, Male, Schizophrenia epidemiology, Socioeconomic Factors, Adverse Drug Reaction Reporting Systems statistics & numerical data, Antipsychotic Agents administration & dosage, Antipsychotic Agents adverse effects, Antipsychotic Agents classification, Practice Patterns, Physicians' statistics & numerical data, Schizophrenia drug therapy
- Abstract
Objective: This study examined the prescribing patterns of several first- (FGAs) and second-generation antipsychotic (SGAs) medications administered to older Asian patients with schizophrenia during the period between 2001 and 2009., Method: Information on hospitalized patients with schizophrenia aged 65 or older was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (2001-2009). There were no older patients in Thailand, therefore data on 467 patients in eight Asian countries and territories including China, Hong Kong SAR, India, Japan, Korea, Malaysia, Singapore, and Taiwan were analysed. Cross-sectional socio-demographic data, clinical characteristics and antipsychotic prescriptions were assessed using a standardized protocol and data collection procedure., Results: Of the 467 patients, 192 patients (41.1%) received FGAs only, 166 (35.5%) received SGAs only and 109 (23.3%) received a combination of FGAs and SGAs. Of the FGAs, haloperidol was the most commonly used (31.3%; mean 9.4 ± 6.7 mg/day), followed by chlorpromazine (15.4%; mean 126.4 ± 156.4 mg/day) and sulpiride (6.6%; mean 375.0 ± 287.0 mg/day). Of the SGAs, risperidone was the most commonly used (31.5%; mean 4.5 ± 2.7 mg/day), followed by olanzapine (13.1%; mean 13.6 ± 6.5 mg/day), quetiapine (7.3%; mean 325.0 ± 237.3 mg/day) and aripiprazole (1.9%; mean 17.6 ± 7.7 mg/day)., Conclusions: FGAs and higher doses of certain SGAs (risperidone, olanzapine and quetiapine) were still commonly dispensed to older Asian patients with schizophrenia. Considering older patients' reduced tolerability of potentially severe side effects associated with FGAs and higher doses of certain SGAs, continuing education and training addressing the rational use of antipsychotics in this population is clearly needed.
- Published
- 2012
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