Publications by authors named "Roy Kallivayalil"

Objective: To identify the COVID-19 pandemic impact on well-being/mental health, coping strategies, and risk factors in adolescents worldwide.

Method: This study was based on an anonymous online multi-national/multi-language survey in the general population (representative/weighted non-representative samples, 14-17 years of age), measuring change in well-being (World Health Organization-Five Well-Being Index [WHO-5]/range = 0-100) and psychopathology (validated composite P-score/range = 0-100), WHO-5 <50 and <29, pre- vs during COVID-19 pandemic (April 26, 2020-June 26, 2022). Coping strategies and 9 a priori- defined individual/cumulative risk factors were measured.

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  • The COH-FIT study is a large, multi-country survey aimed at identifying factors affecting wellbeing and mental health outcomes during the COVID-19 pandemic, involving a representative sample of 121,066 adults.
  • Researchers analyzed both modifiable (like coping strategies and pre-pandemic stress) and non-modifiable factors (such as age, gender, and socioeconomic status), finding significant negative effects on wellbeing and psychopathology scores during the pandemic.
  • The study identified 15 modifiable and 9 non-modifiable risk factors, alongside 13 modifiable and 3 non-modifiable protective factors, emphasizing the importance of social support and coping strategies in mental health outcomes.
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  • There is a lack of comprehensive international studies examining multidimensional mental health and wellbeing before and during the COVID-19 pandemic, particularly identifying at-risk groups and effective coping strategies.
  • The COH-FIT survey, conducted from April 2020 to June 2022 in 30 languages, assessed changes in well-being and psychopathology among over 121,000 participants, revealing significant declines in mental health during the pandemic.
  • Key findings indicated that certain demographics, such as young adults and people in low-income countries, were particularly affected, while coping strategies like exercise, internet use, and maintaining social contacts emerged as the most effective for managing stress.
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Background: As clinical practices with lithium salts for patients diagnosed with bipolar disorder (BD) are poorly documented in Asia, we studied the prevalence and clinical correlates of lithium use there to support international comparisons.

Methods: We conducted a cross-sectional study of use and dosing of lithium salts for BD patients across 13 Asian sites and evaluated bivariate relationships of lithium treatment with clinical correlates followed by multivariate logistic regression modeling.

Results: In a total of 2139 BD participants (52.

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  • This study analyzes the prescription patterns of mood stabilizers, primarily used for bipolar disorder, across 10 Asian countries and highlights their use in treating other psychiatric conditions.
  • It found that more than half of the patients had schizophrenia or similar disorders, and symptoms like irritability and aggression were common targets for treatment.
  • The results suggest that while mood stabilizers are frequently used off-label for various psychiatric diagnoses, the effectiveness and justification of this practice need further research.
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Background: Pharmacoepidemiological studies of clozapine use to treat bipolar disorder (BD), especially in Asia, are rare, although they can provide insights into associated clinical characteristics and support international comparisons of indications and drug dosing.

Methods: We examined the prevalence and clinical correlates of clozapine treatment for BD in 13 Asian countries and regions (China, Hong Kong SAR, India, Indonesia, Japan, Korea, Malaysia, Myanmar, Pakistan, Singapore, Sri Lanka, Taiwan, and Thailand) within an Asian Prescription Patterns Research Consortium. We compared BD patients treated with clozapine or not in initial bivariate comparisons followed by multivariable logistic regression modeling.

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Background: The Collaborative Outcome study on Health and Functioning during Infection Times (COH-FIT; www.coh-fit.com) is an anonymous and global online survey measuring health and functioning during the COVID-19 pandemic.

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Introduction: Drug-induced extrapyramidal syndrome (EPS) remains a major problem in clinical psychiatry. This study aimed to examine the factor structure of drug-induced extrapyramidal symptoms observed in patients with schizophrenia and assessed using the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS).

Methods: The participants were 1478 patients with a diagnosis of schizophrenia whose EPS was assessed using the DIEPSS in India, Indonesia, Japan, Malaysia, and Taiwan in the 2016 REAP AP-4 study.

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Background: Rape is one of the most heinous of acts. It constitutes a major violation of an individual's basic rights and intensely impacts their mental and physical health. Coping skills used to deal with the trauma could provide information on their quality of life (QOL).

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Psychotic symptoms are rarely concurrent with the clinical manifestations of depression. Additionally, whether psychotic major depression is a subtype of major depression or a clinical syndrome distinct from non-psychotic major depression remains controversial. Using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, we developed a machine-learning-algorithm-based prediction model for concurrent psychotic symptoms in patients with depressive disorders.

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Aims: Schizophrenia is a major mental disorder with a wide range of psychiatric symptoms. This study explored the structure of psychiatric symptoms of schizophrenia using network analysis in a large representative Asian sample based on a survey of clinical features and treatment used in schizophrenia patients across 15 countries/territories in Asia.

Methods: Data on the demographic characteristics and psychiatric symptoms in schizophrenia patients were extracted from the dataset of the fourth Research on Asia Psychotropic Prescription for Antipsychotics (REAP-AP) project.

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  • Clozapine combined with electroconvulsive therapy (ECT) is an effective treatment for patients with schizophrenia who do not respond to standard therapies, particularly in Asian populations.
  • A study utilized machine learning techniques, specifically random forest and LASSO models, to create a prediction model identifying key variables that influence the success of this treatment combination, with significant results from a sample of 3,744 patients.
  • Findings highlighted important factors such as inpatient status, BMI, and duration of illness, enabling a more tailored approach in treating schizophrenia through personalized medicine.
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  • * Conducted across 13 Asian countries, the research found that out of 1,647 participants, 13.1% were on high doses, with factors like younger age, male sex, and prior electroconvulsive treatment linked to this higher dosing.
  • * The findings indicate significant variations in MS usage among different countries and highlight specific patient characteristics that could help in the individualized treatment of BD.
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  • - The REAP BD study investigated psychotropic medication prescription patterns for bipolar disorder across 12 Asian countries, highlighting the prevalence of polypharmacy and varied treatment approaches.
  • - Data collected from 2003 patients showed that a majority were on multiple medications: 80.8% took mood stabilizers, 82.14% took antipsychotics, and the study found that 70% of patients were involved in polypharmacy practices.
  • - Results indicated a significant increase in antipsychotic use, with over 80% of patients receiving them, suggesting an emerging trend in their use for treating bipolar disorder.
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The symptom heterogeneity of schizophrenia is consistent with Wittgenstein's analogy of a language game. From the perspective of precision medicine, this study aimed to estimate the symptom presentation and identify the psychonectome in Asian patients, using data obtained from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics. We constructed a network structure of the Brief Psychiatric Rating Scale (BPRS) items in 1438 Asian patients with schizophrenia.

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"Show me a sane man and I will cure him for you."-Carl Jung. Essentially, Jung was saying that a sane man does not exist.

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Objective: Recently, rational polypharmacy approaches have been proposed, regardless of the lower risk and cost of monotherapy. Considering monotherapy as first-line treatment and polypharmacy as rational treatment, a balanced attitude toward polypharmacy is recommended. However, the high prevalence of polypharmacy led the Japanese government to establish a polypharmacy reduction policy.

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Background: The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial.

Methods: The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT - www.

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Introduction: Frontline healthcare workers (HCW) have faced significant plight during the ongoing Coronavirus disease 2019 (COVID-19) pandemic. Studies have shown their vulnerabilities to depression, anxiety disorders, post-traumatic stress, and insomnia. In a developing country like India, with a rising caseload, resource limitations, and stigma, the adversities faced by the physicians are more significant.

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