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Biomedical subjects

R Srinivasa Murthy

Publications and source records attributed to R Srinivasa Murthy.

At least 19 recordsLinked to original sources
PubMed2006

Mental health consequences of war: a brief review of research findings.

Among the consequences of war, the impact on the mental health of the civilian population is one of the most significant. Studies of the general population show a definite increase in the incidence and prevalence of mental disorders. Women are more affected than men. Other vulnerable groups are children, the elderly and the disabled. Prevalence rates are associated with the degree of trauma, and the availability of physical and emotional support. The use of cultural and religious coping strategies is frequent in developing countries.

Journal Article↗
PubMed2005

Community outreach for untreated schizophrenia in rural India: a follow-up study of symptoms, disability, family burden and costs.

BACKGROUND: In resource-poor countries, there remains an alarming treatment gap for people with schizophrenia, particularly those living in rural areas. Decentralization of mental health services, including community-based outreach programmes, represents one obvious strategy for bringing appropriate care to these communities. This study set out to assess the costs and effects of such a programme in rural Karnataka in India. METHOD: Eight rural communities were visited by an outreach team, who identified cases of drug-naive or currently untreated schizophrenia. Recruited cases were provided with appropriate psychotropic medication and psychosocial support, and after obtaining informed consent were assessed every 3 months over one and a half years on symptomatology, disability, family burden, resource use and costs. A repeated-measures analysis was carried out to test for significant change in these outcome measures over this period. RESULTS: A total of 100 cases of untreated schizophrenia were recruited, of whom 28% had never received antipsychotic medication and the remaining 72% had not been on medication for the past 6 months. Summary scores for psychotic symptoms, disability and family burden were all reduced significantly, with particular improvement observed at the first follow-up assessment. Increases in treatment and community outreach costs over the follow-up period were accompanied by reductions in the costs of informal-care sector visits and family care-giving time. CONCLUSIONS: Efforts to organize community-based care such as outreach services for people with schizophrenia living in more remote areas of resource-constrained countries can bring substantial benefits to patients and families alike.

Adult↗
PubMed2005

Is it possible to carry out high-quality epidemiological research in psychiatry with limited resources?

PURPOSE OF REVIEW: This review covers the epidemiological research from developing countries to identify the scope of research in the various aspects of epidemiology and the strengths of research. The period covered is June 2004 to June 2005. The literature survey used searches of Medline, key psychiatric journals and personal correspondence with leading psychiatric researchers from developing countries. RECENT FINDINGS: There is a new interest in epidemiological studies in developing countries. These studies have been driven by three factors, namely international collaboration; specific situations like disasters, terrorism and severe acute respiratory syndrome; and international attention to specific topics like maternal depression. There is limited long-term research on specific conditions. There are a number of leads suggesting local social-cultural factors contribute to the distribution of psychiatric problems. Child psychiatry continues to be low in priority. There is also lack of research in areas such as personality disorders and organic psychiatric disorders. SUMMARY: It is possible to carry out high quality epidemiological research in developing countries. Such research has provided new insights into the distribution, causation, course and outcome of mental disorders. There is need for greater attention to the development of epidemiological assessment tools to suit local conditions. Specific centers/institutions developing long-term research interests on specific subjects would be valuable for future efforts. There is also need to widen the conditions to be studied.

Journal Article↗
PubMed2004

Mental health promotion in post-conflict countries.

Meeting the mental health needs of those persons in conflict and post-conflict situations in the eastern Mediterranean region (EMR) is an important goal of the World Health Organization. Of the 22 countries in the EMR, 85% of the population has been affected by conflict in the past two decades. This has resulted in a high prevalence of mental disorder, most commonly depression, post-traumatic stress disorder and anxiety. A number of innovative, culturally sensitive interventions have been developed to meet the mental health needs of the populations. These include the use of 'focusing' in Afghanistan, the Education for Peace Programme in Lebanon, the United Nations Relief and Works Agency's work with refugees in Gaza, life skills education in Iran and the training of professionals in Afghanistan. In post-conflict situations there are six levels of interventions needed: first, increasing resilience; second, making the family the focus for effective support; third, encouraging community solidarity and traditional methods of support: fourth, using the media in mental health promotion; fifth, the integration of mental health skills of caring for the population with general services; and sixth, focusing on long- rather than short-term measures.

Health Planning↗
PubMed2002

Demand for, access to and use of community mental health care: lessons from a demonstration project in India and Pakistan.

BACKGROUND: A widely promoted model of mental health care and prevention appropriate to many low-income countries is one that is integrated into the local primary health care system. AIMS: To examine the influence of health-seeking behaviours (demand-side factors) and the access to/availability of services (supply-side factors) on local service utilisation patterns for people with common mental disorders. METHOD: Two rural catchment populations outside Bangalore (India) and Rawalpindi (Pakistan), one with the standard primary health care system, the other with additional mental health care training and support, were screened for common mental disorders. Diagnosed cases were interviewed about their use of and perceptions of local health care services (repeated three months later). RESULTS: Individuals' use of integrated mental health and other care was modest. Principal (self-rated) supply-side factors were the cost of care, distance from treatment centre, a perception that care would not be effective, and concerns regarding stigma. Perceptions improved over three months, accompanied by an increased preference for public over private providers, but this was not restricted to the integrated care localities. CONCLUSION: The use (and therefore effectiveness) of mental health services integrated into primary care is influenced by the health-seeking behaviours and perceptions of the local population. Efforts to integrate mental health into primary care need to be accompanied by educational activities in order to increase awareness, reduce stigma and draw attention to the availability of effective treatment.

Adolescent↗
PubMed1990

Development of case vignettes to assess the mental health training of primary care medical officers.

This article reports the development of case vignettes as a method of assessing the short-term in-service training of primary care medical officers in mental health care. A pool of 18 case vignettes representing common psychiatric problems and a standard response sheet were written first. This was mailed to 45 psychiatrists for their comments. Based on the comments received from 21 psychiatrists, 2 sets of questionnaires with 7 vignettes in each set were developed. When administered to a group of 32 medical officers, this method of assessment was found to be sensitive in detecting gain in knowledge and skills following training. Further, performance on case vignettes was found to correlate positively with clinical skills when actual cases were given for assessment.

Curriculum↗
PubMed1990

Training primary care medical officers in mental health care: an evaluation using a multiple-choice questionnaire.

This report aimed to evaluate the mental health knowledge of primary care medical officers following short-term training in mental health care using a multiple-choice questionnaire. Seventy-eight medical officers who underwent 2 weeks' training in mental health care were assessed using parallel forms of a standardized multiple-choice questionnaire administered before and soon after the training. Young doctors scored significantly higher in the pretraining assessment. The medical officers demonstrated a significant gain in knowledge, although the amount of gain varied. Doctors who had relatively lower pretraining scores showed a higher gain. Six doctors (8%) showed less than acceptable posttraining scores. These doctors were older than the rest of the group. The doctors' pretraining knowledge was best with respect to epilepsy and poorest with respect to manic-depressive psychosis. Items pertaining to epidemiology and aetiology elicited relatively less gain than other clinical dimensions.

Adult↗
PubMed1986

A nosological study of patients presenting with somatic complaints.

The nosological status of patients presenting with multiple somatic complaints with reference to ICD-9 was examined in the present study. In 22% of the cases it was not possible to arrive at a single ICD-9 diagnosis. The majority of these cases had combinations of somatic, anxiety and depressive symptoms. Nine percent of the cases could not be given any psychiatric diagnosis using ICD-9. These cases had very few psychological symptoms and were not identified as psychiatric cases by the present state examination. The various possible factors responsible for this diagnostic uncertainty have been highlighted.

Adolescent↗
PubMed1983

Saliva lithium levels for monitoring lithium prophylaxis of manic depressive psychosis.

The usefulness of salivary lithium values for monitoring long-term lithium prophylaxis was studied in 60 patients on lithium therapy. A total of 99 pairs of saliva and serum samples were obtained, and the correlation between serum and salivary lithium levels (r = 0.73) was found to be significant at the 1% level. The ratio of salivary serum levels to that of serum was found to range from 1.77 to 6.68. The ratio of 51% of the samples was between 3 and 3.99. It is therefore suggested that it is important to identify the subgroup of patients who show better correlation of salivary and serum lithium levels and use each individual's ratio to monitor only his lithium therapy.

Bipolar Disorder↗
PubMedDate not supplied

The International Consortium on Mental Health Policy and Services: objectives, design and project implementation.

The concept of the burden of disease, introduced and estimated for a broad range of diseases in the World Bank report of 1993 illustrated that mental and neurological disorders not only entail a higher burden than cancer, but are responsible, in developed and developing countries, for more than 15% of the total burden of all diseases. As a consequence, over the past decade, mental disorders have ranked increasingly highly on the international agenda for health. However, the fact that mental health and nervous system disorders are now high on the international health agenda is by no means a guarantee that the fate of patients suffering from these disorders in developing countries will improve. In most developing countries the treatment gap for mental and neurological disorders is still unacceptably high. To address this problem, an international network of collaborating institutions in low-income countries has been set up. The establishment and the achievements of this network--the International Consortium on Mental Health Policy and Services--are reported. Sixteen institutions in developing countries collaborate (supported by a small number of scientific resource centres in industrialized nations) in projects on applied mental health systems research. Over a two-year period, the network produced the key elements of a national mental health policy; provided tools and methods for assessing a country's current mental health status (context, needs and demands, programmes, services and care and outcomes); established a global network of expertise, i.e., institutions and experts, for use by countries wishing to reform their mental health policy, services and care; and generated guidelines and examples for upgrading mental health policy with due regard to the existing mental health delivery system and demographic, cultural and economic factors.

Consensus↗