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Thekkumkara SN, Jagannathan A, Sivakumar T. Pradhan Mantri Kaushal Vikas Yojana (PMKVY): Implications for Skills Training and Employment of Persons With Mental Illness. Indian J Psychol Med 2022; 44:173-176. [PMID: 35655990 PMCID: PMC9120997 DOI: 10.1177/0253717621997180] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sreekanth Nair Thekkumkara
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Aarti Jagannathan
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Thanapal Sivakumar
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Mehta VS, Ram D. A Mixed-Methods Approach to Evaluate the Needs, Support, and Services for Common Mental Disorders: A Protocol Examining Two Community Extension Clinics. Indian J Psychol Med 2020; 42:S57-S62. [PMID: 33487804 PMCID: PMC7802027 DOI: 10.1177/0253717620971985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The social, economic, and physical environments are widely recognized as important determinants of health and affect the outcome of service delivery. The differences in the patient outcomes can be inferred upon by looking into the process and content of service delivery. METHODS This study is a mixed-methods, prospective cohort study to be conducted at two community extension clinics run by the Central Institute of Psychiatry, Ranchi, Jharkhand. Service users diagnosed with a common mental disorder (CMDs) will be recruited during the study period of three years. The main objective is to ascertain the unmet needs of patients with CMDs. The secondary goals involve measuring the clinical outcome through the lens of process-oriented recovery, service satisfaction, and accessibility, and analyzing the barriers to access healthcare services along with the impact on the carers. Focus group discussions with participants will help understand the reasons behind their unmet needs and factors essential in service delivery. DISCUSSION Healthcare, as well as social care, aims to deliver services according to need. In a country with 15 million people with CMDs, evaluation of needs could create a platform for the rational distribution of services.
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Affiliation(s)
- Varun S. Mehta
- Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India
- Varun S Mehta, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India. E-mail:
| | - Daya Ram
- Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India
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Agarwal AK. Psychiatric practice: Some personal observations. Indian J Psychiatry 2020; 62:644-649. [PMID: 33896968 PMCID: PMC8052892 DOI: 10.4103/psychiatry.indianjpsychiatry_249_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/30/2020] [Accepted: 04/17/2020] [Indexed: 12/03/2022] Open
Affiliation(s)
- Anil Kumar Agarwal
- Retired Professor, Department of Psychiatry, K. G's. Medical College, Lucknow, Uttar Pradesh, India
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Deolia SG, Khare MV, Arora RP, Chikhale RN, Korde RD, Reche AM. Assessment of the oral health seeking behavior of patients with premalignant lesions. J Family Med Prim Care 2020; 9:141-146. [PMID: 32110580 PMCID: PMC7014843 DOI: 10.4103/jfmpc.jfmpc_636_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/04/2019] [Accepted: 11/20/2019] [Indexed: 11/04/2022] Open
Abstract
Background: Before choosing/visiting any dental facility for their treatment, patients consider several factors. These factors may be related to the patient or service provider. The health-seeking behavior of a society defines how health services are used. Aims: To assess the health seeking behavior of patients with premalignant lesions. Material and Method: A cross sectional study using questionnaire was done among the patients who consulted in the Department of Oral Medicine and Radiology, of age 18 and above suffering from precancerous lesions. The questionnaire included 25 close-ended questions which collected information about the demographic details, oral hygiene habits, oral health issues, deleterious habits. The responses were either on dichotomous scale (yes and no) or on the frequency habits. A total of 218 subjects were included in the study. The data were analyzed using the Chi-square test. The acceptable level of significance was reduced to P < 0.05. Result: Slightly over 50% of study participants visited the dentist for their dental problems. Most of the participants visited dental clinic whenever needed. Maximum positive health seeking behavior is seen in fourth and fifth decade and minimum seen in second and third decade. Conclusion: The oral premalignant lesions have high chances of transformation into malignancies. The progression of these lesions can be prevented by stopping the progression at an early stage and thus instilling positive health seeking behavior serves as an important key to it.
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Affiliation(s)
- Shravani G Deolia
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, DMIMS, Wardha, Maharashtra, India
| | - Mrunmayee V Khare
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, DMIMS, Wardha, Maharashtra, India
| | - Ritika P Arora
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, DMIMS, Wardha, Maharashtra, India
| | - Rana N Chikhale
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, DMIMS, Wardha, Maharashtra, India
| | - Revti D Korde
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, DMIMS, Wardha, Maharashtra, India
| | - Amit M Reche
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, DMIMS, Wardha, Maharashtra, India
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Kar SK, Roy P, Singh J, Tripathi A, Dalal PK. Clinical profile and correlates of hospital stay in patients with severe mental illness. Asian J Psychiatr 2019; 45:41-43. [PMID: 31493623 DOI: 10.1016/j.ajp.2019.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/27/2019] [Accepted: 08/27/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, U.P, India.
| | - Pritha Roy
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, U.P, India.
| | - Jai Singh
- Department of Psychiatry, King George's Medical University, Lucknow, U.P, India.
| | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, U.P, India.
| | - Pronob Kumar Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, U.P, India.
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Kumar G, Sood M, Verma R, Mahapatra A, Chadda RK. Family caregivers' needs of young patients with first episode psychosis: A qualitative study. Int J Soc Psychiatry 2019; 65:435-442. [PMID: 31190603 DOI: 10.1177/0020764019852650] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The caregivers of patients with first episode psychosis (FEP) experience significant distress. It is important to understand their needs to plan adequate interventions for them. AIM The aim of this study was to explore the needs of caregivers of young patients with FEP in India, using a qualitative approach. METHODS The study was conducted in two phases. In phase I, a script for conducting focus group discussions (FGDs) with caregivers was developed, based on literature search and expert opinion generated from FGD with mental health professionals. In phase II, five FGDs were conducted with 30 caregivers of young patients with FEP having minimal of 6 participants in each FGD. Data was analyzed using principles of grounded theory. RESULTS Seven broad themes and subthemes of the needs of caregivers emerged from the FGDs. The final themes, which highlighted the needs of caregivers of young patients with FEP, were (in order of ranking) as follows: information regarding treatment, information regarding illness, services provided by the government, optimum quality of care from treatment facility, management of psychosocial issues related to patient's illness, availability and accessibility of treatment, and identification and recognition of mental health and physical problems in family members. CONCLUSION Qualitative method was useful to identify the needs of the caregivers of young patients with FEP in multiple domains.
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Affiliation(s)
- Ganesh Kumar
- 1 Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Mamta Sood
- 1 Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Rohit Verma
- 1 Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Ananya Mahapatra
- 2 Dr. Ram Manohar Hospital and Postgraduate Institute of Medical Education and Research, New Delhi, India
| | - Rakesh Kumar Chadda
- 1 Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Abstract
While there have been significant advances in treatments for mental disorders over the past century, cure for many mental disorders remains elusive. The complex problems of mental illness require a multi-sectoral, multi-disciplinary and multi-dimensional approach to care. The need for focus on biopsychosocial model rather than on biomedical practise, client-centred rather than physician-oriented care, personal rather than clinical recovery, are often preached but rarely practiced. The lack of emphasis on functioning and the limited workforce and evidence base complicate issues related to the care of people with chronic mental illness in India. The role of occupational therapy in bridging the gap between symptomatic improvement and functional recovery is discussed.
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Affiliation(s)
- Reema Samuel
- Occupational Therapy Education and Services, Christian Medical College, Vellore, Tamil Nadu, India
| | - K S Jacob
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
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Neogi R, Chakrabarti S, Grover S. Health-care needs of remitted patients with bipolar disorder: A comparison with schizophrenia. World J Psychiatry 2016; 6:431-441. [PMID: 28078207 PMCID: PMC5183995 DOI: 10.5498/wjp.v6.i4.431] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 09/18/2016] [Accepted: 10/18/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To investigate health-care needs and their correlates among patients with remitted bipolar disorder (BD) compared to patients with remitted schizophrenia.
METHODS Outpatients with BD (n = 150) and schizophrenia (n = 75) meeting clearly defined remission criteria were included in the study along with their relatives. Diagnostic ascertainment was carried out using the Mini International Neuropsychiatric Interview. Demographic and clinical details were recorded using structured formats. Residual symptoms were assessed using standardized scales. Health-care needs were assessed on two separate scales. The principal instrument employed to assess health-care needs was the Camberwell Assessment of Need-Research version (CAN-R). To further evaluate health-care needs we felt that an additional instrument, which was more relevant for Indian patients and treatment-settings and designed to cover those areas of needs not specifically covered by the CAN-R was required. This instrument with a structure and scoring pattern similar to the CAN-R was used for additional evaluation of needs. Patients’ level of functioning was assessed using the Global Assessment of Functioning Scale and their quality of life (QOL) using the World Health Organization Quality Of Life-BREF version in Hindi.
RESULTS An average of 6-7 needs was reported by patients with BD as well as their relatives. Commonly reported needs were in the areas of economic and welfare needs, informational needs, social needs and the need for treatment. According to the CAN-R, both patients and relatives reported that more than 60% of the total needs were being met. However, over 90% of the needs covered by the additional evaluation were unmet according to patients and relatives. Needs in the areas of economic and welfare-benefits, information, company, daytime activities and physical health-care were largely unmet according to patients and relatives. Total, met and unmet needs were significantly higher for schizophrenia, but the most common types of needs were quite similar to BD. Relatives reported more needs than patients with certain differences in the types of needs reported. Level of patients’ functioning was the principal correlate of greater total and unmet needs in both groups. Significant associations were also obtained with residual symptoms and QOL.
CONCLUSION The presence of unmet needs in remitted patients with BD was an additional marker of the enduring psychosocial impairment characteristic of the remitted phase of BD.
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Johnson JM, Wu CY, Winder GS, Casher MI, Marshall VD, Bostwick JR. The Effects of Cannabis on Inpatient Agitation, Aggression, and Length of Stay. J Dual Diagn 2016; 12:244-251. [PMID: 27710762 DOI: 10.1080/15504263.2016.1245457] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study examines the association between cannabis use and the hospital course of patients admitted to the psychiatric inpatient unit with a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder. Many confounding variables potentially contribute to the clinical presentation of hospitalized patients in the psychiatric unit. Illicit drug use, in particular, has been associated with acute agitation, and questions can be raised as to what lasting effects drug use prior to admission may have throughout a patient's hospital stay. METHODS Subjects with a discharge diagnosis of bipolar disorder, schizophrenia, schizoaffective disorder, or psychosis not otherwise specified (N = 201) were retrospectively identified, and those with positive results of urine drug screen for cannabis on admission were compared to negative counterparts. Agitation and aggression were measured using an adaptation of the Excited Component of the Positive and Negative Syndrome Scale (PANSS-EC). These markers were also quantified by comparing charted episodes of restraint and seclusion and administration of as needed medications, such as benzodiazepines and antipsychotics. RESULTS Positive urine drug screen results for cannabis was correlated with young (p = .001) males (p = .003) with bipolar disorder (p = .009) exhibiting active manic symptoms (p = .003) at the time of admission. Cannabis use was further associated with a shorter length of stay (p = .008), agitation triggering adapted PANSS-EC nursing assessments (p = .029), and oral medications as needed (p = .002) for agitation. CONCLUSIONS Cannabis use, as defined by positive urine drug screen results, was more common in patients with bipolar disorder and was accompanied by a higher incidence of inpatient agitation. Although these patients also had short hospital lengths of stay, there was no clear relationship between level of agitation and length of stay across all patient groups. One possible explanation for patients with bipolar disorder experiencing short lengths of stay is that their source of agitation may be more closely related to a complex effect of cannabis use rather than a sole etiology of mental illness. Inpatient clinicians should be aware of patient cannabis use proximate to admission.
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Affiliation(s)
- Joseph M Johnson
- a Detroit Medical Center-Detroit Receiving Hospital , Detroit , Michigan , USA
| | - Chris Y Wu
- b University of Michigan Health System , Ann Arbor , Michigan , USA
| | - Gerald Scott Winder
- c Department of Psychiatry , University of Michigan , Ann Arbor , Michigan , USA
| | - Michael I Casher
- c Department of Psychiatry , University of Michigan , Ann Arbor , Michigan , USA
| | - Vincent D Marshall
- d University of Michigan College of Pharmacy , Ann Arbor , Michigan , USA
| | - Jolene R Bostwick
- d University of Michigan College of Pharmacy , Ann Arbor , Michigan , USA.,e Department of Pharmacy Services , University of Michigan , Ann Arbor , Michigan , USA
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Waghmare A, Sherine L, Sivakumar T, Kumar CN, Thirthalli J. Rehabilitation Needs of Chronic Female Inpatients Attending Day-care in a Tertiary Care Psychiatric Hospital. Indian J Psychol Med 2016; 38:36-41. [PMID: 27011400 PMCID: PMC4782442 DOI: 10.4103/0253-7176.175104] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Female patients hospitalized for a long duration in psychiatric hospitals are a special population with unique needs. AIMS AND OBJECTIVES To assess rehabilitation needs of chronic female inpatients attending psychiatric rehabilitation services in a tertiary care psychiatric hospital. MATERIALS AND METHODS Rehabilitation needs of nine chronic female inpatients were assessed with an interview schedule developed by expert consensus. The needs were elicited from the patients. Perspectives of nursing staff, vocational instructors, and treating psychiatrists were also sought. RESULTS AND CONCLUSION Most patients expressed the need for more incentives for working in day-care, variety in food and grooming items. The nursing staff felt many patients could be placed outside, and the family members should come more frequently to meet them. Vocational instructors felt that patients need more incentives, variety in food and work. Treating psychiatrists said that major barriers in discharging and placing them were nonavailability or poor involvement of family members. Services like supported housing, supported education and supported employment are necessary to cater to their complex needs.
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Affiliation(s)
- Avinash Waghmare
- Smt. Kashibai Navale Medical College, Pune, Maharashtra, India; Department of Psychiatry, Psychiatric Rehabilitation Services, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Linda Sherine
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Thanapal Sivakumar
- Department of Psychiatry, Psychiatric Rehabilitation Services, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - C Naveen Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Andrade MCR, Slade M, Bandeira M, Evans-Lacko S, Komaroff J, Martin D, Mari JDJ, Andreoli SB. Subjective distress in a representative sample of outpatients with psychotic disorders. J Affect Disord 2016; 189:220-3. [PMID: 26451507 DOI: 10.1016/j.jad.2015.08.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND The affective burden of psychotic disorder has been increasingly recognised. However, subjective reports of distress and its covariates, especially those related to service use, remain under-investigated in patients with psychosis. METHODS This study investigated subjective distress and its covariates in a representative sample of 401 outpatients with a confirmed diagnosis of psychotic disorders in Brazil. Distress was assessed using the corresponding domain of a standardised measure of need - the Camberwell Assessment of Need. RESULTS Distress was reported as a need by 165 (41%) patients, being met in 78 (20%) and unmet in 87 (22%). Hierarchical logistic regression showed that the presence of distress as a need was predicted by attendance at psychotherapy (OR=3.49, CI=1.62-7.53), presence of suicidal ideation (OR=2.89, CI=1.75-4.79), non-attendance at psychosocial rehabilitation (OR=2.84, CI=1.31-6.19), and higher psychopathology (OR=1.09, CI=1.06-1.12). An unmet need was predicted by family not accompanying patients to treatment (OR=2.60, CI=1.05-6.44) and higher psychopathology (OR=1.05, CI=1.02-1.09). LIMITATION The use of a cross-sectional design and a single questionnaire domain to evaluate distress are the main limitations. CONCLUSIONS Subjective distress is a common unmet need in psychosis, and can be treated. The main clinical implication is that subjective distress in psychosis may be impacted on by family engagement and psychosocial interventions.
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Affiliation(s)
- Mário César Rezende Andrade
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Borges Lagoa, 570, Vila Clementino, São Paulo 04038-020, Brazil; King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
| | - Mike Slade
- King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Marina Bandeira
- Department of Psychology, Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, Brazil
| | - Sara Evans-Lacko
- King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK; London School of Economics and Political Science, London, UK
| | - Janina Komaroff
- Centre de Recherche de Montréal sur les Inégalités Sociales et les Discriminations (CREMIS), Montréal, Quebec, Canada
| | - Denise Martin
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Borges Lagoa, 570, Vila Clementino, São Paulo 04038-020, Brazil; Universidade Católica de Santos, Santos, Brazil
| | - Jair de Jesus Mari
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Borges Lagoa, 570, Vila Clementino, São Paulo 04038-020, Brazil; King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Sérgio Baxter Andreoli
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Borges Lagoa, 570, Vila Clementino, São Paulo 04038-020, Brazil; Universidade Católica de Santos, Santos, Brazil
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Grover S, Avasthi A, Shah S, Lakdawala B, Chakraborty K, Nebhinani N, Kallivayalil RA, Dalal PK, Sinha V, Khairkar P, Mukerjee DG, Thara R, Behere P, Chauhan N, Thirunavukarasu M, Malhotra S. Indian Psychiatric Society multicentric study on assessment of health-care needs of patients with severe mental illnesses as perceived by their family caregivers and health-care providers. Indian J Psychiatry 2015; 57:181-9. [PMID: 26124525 PMCID: PMC4462788 DOI: 10.4103/0019-5545.158185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
AIM To study the health-care needs of the patients with severe mental disorders as perceived by their family caregivers and the treating psychiatrists. MATERIALS AND METHODS Caregivers of patients with severe mental disorders and their treating psychiatrists were assessed using Camberwell Assessment of Need-Research Version (CAN-R) scale and indigenously designed Supplementary Assessment of Needs Scale (SNAS). RESULTS The study included 1494 patients recruited from 15 centers. The mean needs as per the CAN-R, perceived by the caregivers were 7.8 and treating psychiatrists were 8.1. About one-third of needs were unmet. On SNAS, both caregivers and treating psychiatrists reported a mean of 7.9 needs, of which more than half were unmet as per the caregivers. As per the treating psychiatrists, 45.5% of the needs as assessed on SNAS were unmet. There was a high level of correlation between needs perceived by the patients, caregivers and the treating psychiatrists. On CAN-R, main domains of needs as reported by the caregivers were those of money, relief of psychological distress, information about the illness and treatment, welfare benefits, transport, company and food. As per the treating psychiatrists, the most common total needs identified were those of relief of psychological distress, welfare benefits, information about the illness and treatment, money, transport, company self-care and physical health. The most common domains of needs as assessed on SNAS as per the caregivers were those of free treatment, medical reimbursement, psychoeducation, financial help, social support, insurance, more time from the clinicians and travel concession. The treating psychiatrists identified dealing with caregiver's stress as the most common need. CONCLUSIONS According to the family caregivers and treating psychiatrists, about one-third of the needs of the patients as assessed using CAN-R and about half of the needs as assessed using SNAS are unmet.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandip Shah
- Department of Psychiatry, SBKS MI and RC, Sumandeep Vidyapeeth, Pipaira, Vadodara, Gujarat, India
| | - Bhavesh Lakdawala
- Department of Psychiatry, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Kaustav Chakraborty
- Department of Psychiatry, College of Medicine and J.N.M. Hospital, Kalyani, India
| | | | - Roy A Kallivayalil
- Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Tiruvalla, Kerala, India
| | - Pranob K Dalal
- Department of Psychiatry, KGMU, Lucknow, Uttar Pradesh, India
| | - Vishal Sinha
- Department of Psychiatry, S. N. Medical College, Agra, Uttar Pradesh, India
| | - Praveen Khairkar
- Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India
| | - Divya G Mukerjee
- Department of Psychiatry, R. G. Kar Medical College, Kolkata, West Bengal, India
| | - R Thara
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | - Prakash Behere
- Department of Psychiatry, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | | | - M Thirunavukarasu
- Department of Psychiatry, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India
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Grover S, Chakrabarti S, Ghormode D, Dutt A. A comparative study of caregivers' perceptions of health-care needs and burden of patients with bipolar affective disorder and schizophrenia. Nord J Psychiatry 2015; 69:629-36. [PMID: 25928091 DOI: 10.3109/08039488.2015.1033010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Although many studies in schizophrenia have evaluated health-care needs, there is a lack of data on the needs of patients with bipolar affective disorder (BPAD), with only occasional studies evaluating them, and no study has evaluated the relationship of health-care needs of patients with caregiver's burden. AIM To study the relationship of caregiver's burden and needs of patients as perceived by caregivers of patients with BPAD and schizophrenia. METHOD Caregivers of patients with BPAD and schizophrenia were assessed using the Camberwell Assessment of Needs - Research version (CAN-R) and Supplementary Needs Assessment Scale (SNAS), the Family Burden Interview schedule (FBI) and the Involvement Evaluation Questionnaire (IEQ). RESULTS Mean total needs of patients on CAN-R were 7.54 (SD 3.59) and 7.58 (SD 4.24) for BPAD and schizophrenia respectively. Mean total needs for SNAS were 7.24 (SD 3.67) and 7.68 (SD 5.02) for BPAD and schizophrenia groups, respectively. Total objective and subjective burden as assessed on FBI was significantly more for the schizophrenia group. Caregivers of patients with BPAD perceived significantly less disruption of routine family activities and lower impact on the mental health of others. On IEQ, the mean score on the domain of supervision was significantly higher for the BPAD group. In the schizophrenia group, positive correlations were seen between the total number of unmet and total (met and unmet) needs and certain aspects of burden, but no such correlations emerged in the BPAD group. CONCLUSION There is no correlation between number of needs and burden in the BPAD group; however, in the schizophrenia group the number of needs correlated with the perceived burden. Accordingly, orienting services to address needs of patients with schizophrenia can lead to reduction in burden among caregivers.
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Affiliation(s)
- Sandeep Grover
- a Sandeep Grover, Department of Psychiatry , Post Graduate Institute of Medical Education and Research , Chandigarh , India
| | - Subho Chakrabarti
- b Subho Chakrabarti, Department of Psychiatry , Post Graduate Institute of Medical Education and Research , Chandigarh , India
| | - Deepak Ghormode
- c Deepak Ghormode, Department of Psychiatry , Post Graduate Institute of Medical Education and Research , Chandigarh , India
| | - Alakananda Dutt
- d Alakananda Dutt, Department of Psychiatry , Post Graduate Institute of Medical Education and Research , Chandigarh , India
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