Publications by authors named "Suhas Satish"

Introduction: The ST population, residing in isolated, underdeveloped areas, faces significant health disparities compared to non-tribal communities. In particular, the lack of mental health infrastructure in these regions exacerbates their health challenges. Tribal communities possess distinct cultural beliefs surrounding health and illness, yet scant information exists regarding their physical and mental well-being.

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The response rate to clozapine in patients with treatment-resistant schizophrenia spectrum disorders (TRSS) is around 40 %. But, in general, a better prognosis is noted for schizophrenia in developing countries, including India. Given the scarcity of related literature from India, this study aimed to evaluate the response rates to clozapine in TRSS and explore predictors of response.

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Introduction: Agitation, a significant psychiatric issue often linked to conditions like schizophrenia, bipolar disorder, and major depression, invariably pose challenges in emergency settings. Acute agitation occurs in 2.6 % of emergency cases and up to 12.

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Article Synopsis
  • This review discusses the evolution and current situation of psychiatry education in India, highlighting historical changes, ongoing training practices, and challenges faced by the system.
  • It utilizes published literature and documents from important organizations like the Indian Psychiatric Society and the National Medical Commission to gather insights.
  • A key finding is that while psychiatry training has improved significantly, there is a critical need for structured training in teaching and leadership for resident doctors transitioning to faculty roles, leading to a recommendation for a comprehensive faculty development program.
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Wilson disease is a rare genetic disorder of copper metabolism causing hepatic dysfunction and neuro-psychiatric manifestations. While psychosis in Wilson disease is uncommon, it can occur, especially with certain medications. We describe a 40-year-old woman diagnosed with Wilson disease who developed psychotic symptoms following the initiation and dose escalation of amantadine, a drug commonly used to treat parkinsonism associated with the disorder.

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  • Transcranial Direct Current Stimulation (tDCS) is a noninvasive brain stimulation method that shows promise in helping individuals with schizophrenia manage auditory verbal hallucinations (AVH).
  • Traditional in-clinic tDCS requires frequent visits due to its short-lived effects, but home-based tDCS could provide a more accessible solution if safety and standardization measures are implemented.
  • A case study demonstrated successful administration of tDCS at home with proper caregiver training and a standard operating procedure (SOP), leading to sustained improvements in AVH over ten days without adverse effects.
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  • Dysregulated prediction error-signalling may lead to auditory hallucinations in schizophrenia, with metrics like rMMN, RP, DN, and MMN helping to assess this relationship.* -
  • In a study involving 23 schizophrenia patients with auditory hallucinations and 23 healthy controls, significant differences were found in deviance detection and prediction error signaling, particularly with DN and MMN amplitudes being lower in the patients.* -
  • The results suggest that auditory hallucinations interfere with sensory adaptation and detection abilities, indicating that schizophrenia patients may not process auditory information effectively despite unimpaired short-term memory responses.*
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  • PTSD is a chronic mental health condition linked to major distress, with global prevalence ranging from 3.9% to 24%, but significantly under-researched in India.
  • The National Mental Health Survey 2015-2016, involving over 39,000 individuals, found a low PTSD prevalence of just 0.2% in India, influenced by factors like female gender, middle age, and urban living.
  • The study highlights challenges in accurately diagnosing PTSD in India due to cultural factors and stigma, emphasizing the need for tailored treatment approaches and better awareness.
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Introduction: Panic disorder (PD) is one of the most common and debilitating anxiety disorder. Individuals with PD seek frequent healthcare and emergency services leading to frequent work absenteeism and economic burden. However, its prevalence patterns in the Indian context are poorly understood.

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  • Generalized anxiety disorder (GAD) is a common yet under-researched anxiety disorder, and the study aims to provide epidemiological data from India’s National Mental Health Survey (NMHS) 2016 to understand its prevalence and impact.
  • The survey found that the weighted prevalence of GAD is 0.57%, with higher odds in urban, married individuals, and those with comorbid conditions like depression.
  • The study highlights a significant treatment gap of 75.7% for GAD, indicating that a large number of affected individuals are not receiving adequate care.*
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Introduction: Schizophrenia spectrum disorders represent a significant global health concern, contributing significantly to the global burden of disease. The National Mental Health Survey (NMHS) of India, conducted between 2015 and 2016, investigated the prevalence and epidemiological correlates of schizophrenia spectrum disorders in India.

Materials And Methods: The NMHS conducted a population-based cross-sectional study in 12 Indian states from 2015 to 2016, encompassing 34,802 adults.

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The National Mental Health Survey of India (NMHS) was a ground-breaking nationwide study that harnessed a uniform, standardized methodology blending quantitative and qualitative approaches. Covering data from 12 states across diverse regions, its mission was to gauge the prevalence of psychiatric disorders, bridge treatment gaps, explore service utilization, and gauge the socioeconomic repercussions of these conditions. This initiative provided pivotal insights into the intricate landscape of mental health in India.

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Background: A staggering 85% of the global population resides in low- and middle-income countries (LAMICs). India stands as an exemplary pioneer in the realm of mental health initiatives among LAMICs, having launched its National Mental Health Program in 1982. It is imperative to effectively evaluate mental health systems periodically to cultivate a dynamic learning model sustained through continuous feedback from mental healthcare structures and processes.

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Background: Social anxiety disorder (SAD), also termed as social phobia, is a disabling psychiatric condition with limited epidemiological research on it in India. This study, using data from the National Mental Health Survey (NMHS), 2016, is the first to explore its current prevalence and associated factors in India.

Materials And Methods: The NMHS in India used a comprehensive population-based study with subjects selected through a multistage stratified random cluster sampling technique across 12 states.

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Background: Up to 1/2 of outpatients prescribed clozapine may be partially/fully non-adherent, based on therapeutic drug monitoring (TDM). Three indices for measuring partial/full non-adherence are proposed a: 1) clozapine concentration/dose (C/D) ratio which drops to half or more of what is expected in the patient; 2) clozapine/norclozapine ratio that becomes inverted; and 3) clozapine concentration that becomes non-detectable.

Methods: These 3 proposed indices are based on a literature review and 17 cases of possible non-adherence from 3 samples: 1) an inpatient study in a Chinese hospital, 2) an inpatient randomized clinical trial in a United States hospital, and 3) and a Uruguayan outpatient study.

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The study was designed to examine the mental health impact of COVID-19 infection in postpartum women and its effects on mother-infant bonding during the first eight weeks postpartum. Fifty-seven consenting eligible postpartum women were recruited for the study. They were assessed at two time points using standardized rating scales to measure distress and uniquely designed scales assessing COVID-19-specific outcome fears and bonding.

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During weak induction (from smoking and/or valproate co-prescription), clozapine ultrarapid metabolizers (UMs) need very high daily doses to reach the minimum therapeutic concentration of 350 ng/ml in plasma; clozapine UMs need clozapine doses higher than: 1) 900 mg/day in patients of European/African ancestry, or 2) 600 mg/day in those of Asian ancestry. Published clozapine UMs include 10 males of European/African ancestry, mainly assessed with single concentrations. Five new clozapine UMs (two of European and three of Asian ancestry) with repeated assessments are described.

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Background: Community health workers such as Accredited Social Health Activists (ASHAs) are existing resources who can facilitate the bridging of the mental health treatment gap. Knowing about the perspectives of ASHAs in delivering mental health care and other professionals with experience working in the area of community mental health is imperative.

Method: As part of an implementation research project aimed at comparing the effectiveness of two training methods for community health workers (ASHAs), we conducted five focussed group discussions including four with ASHAs ( = 34) and one with other stakeholders ( = 10).

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