1
|
Jagadheesan K, Patterson R, Chapman D, Jovanova G, Ewais T, Heffernan P, Koko Aung E. Attention deficit hyperactivity disorder conundrum: Access to care and psychiatric training. Australas Psychiatry 2024:10398562241230193. [PMID: 38389484 DOI: 10.1177/10398562241230193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
|
2
|
Suetani S, Giam A, Jagadheesan K. Adult attention deficit and hyperactivity disorder: How can we put the cart behind the horse? Aust N Z J Psychiatry 2023; 57:1089-1090. [PMID: 37122128 DOI: 10.1177/00048674231170558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Shuichi Suetani
- Institute for Urban Indigenous Health, Windsor, QLD, Australia
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
- The University of Queensland, Brisbane, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia
| | - Andrew Giam
- Cramond Clinic, Woodville South, SA, Australia
- School of Medicine, The University of Adelaide, Adelaide, SA, Australia
- Central Adelaide Local Health Network, Adelaide, SA, Australia
| | - Karuppiah Jagadheesan
- North West Area Mental Health Service, Broadmeadows, VIC, Australia
- Swinburne University of Technology, Hawthorn, VIC, Australia
| |
Collapse
|
3
|
May T, Birch E, Chaves K, Cranswick N, Culnane E, Delaney J, Derrick M, Eapen V, Edlington C, Efron D, Ewais T, Garner I, Gathercole M, Jagadheesan K, Jobson L, Kramer J, Mack M, Misso M, Murrup-Stewart C, Savage E, Sciberras E, Singh B, Testa R, Vale L, Weirman A, Petch E, Williams K, Bellgrove M. The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder. Aust N Z J Psychiatry 2023; 57:1101-1116. [PMID: 37254562 PMCID: PMC10363932 DOI: 10.1177/00048674231166329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The objective of this article was to provide an overview of the development and recommendations from the Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder (ADHD). The guideline aims to promote accurate and timely identification and diagnosis, and optimal and consistent treatment of ADHD. METHODS Development integrated the best available evidence with multidisciplinary clinical expertise and the preferences of those with lived experience, underpinned by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. The 23 guideline development group members included psychiatrists, paediatricians, general practitioners, psychologists, speech pathologists, occupational therapists, educators, Indigenous psychologists, and people with a lived experience; with two independent chairs and a methodologist. Where appropriate, evidence reviews from the National Institute for Health and Care Excellence (NICE) 2018 'Attention Deficit Hyperactivity Disorder: Diagnosis and Management' guideline were updated. Fifty prioritised clinical questions were addressed in 14 systematic reviews (new and updated from NICE 2018) and 28 narrative reviews. RESULTS The 113 clinical recommendations apply to young children (5 years and under), children, adolescents and adults. They provide guidance for clinicians on identification, screening, diagnosis, multimodal treatment and support, including pharmacological and non-pharmacological interventions. The guideline and supporting information are available online: https://adhdguideline.aadpa.com.au/. CONCLUSIONS The guideline was approved by the National Health and Medical Research Council (NHMRC) of Australia and relevant medical and allied health professional associations. It is anticipated that successful implementation and uptake of the guideline by organisations, health care providers and other professionals will increase delivery of evidence-based treatment and improve health outcomes for the more than 800,000 Australians with ADHD.
Collapse
Affiliation(s)
- Tamara May
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | | | | | - Noel Cranswick
- Clinical Pharmacology Unit, Department of Medicine and Melbourne Children’s Trials Centre, Royal Children’s Hospital, Parkville, Vic, Australia
- Murdoch Children’s Research Institute, Parkville Vic, Australia
- University of Melbourne, Parkville, VIC, Australia
| | - Evelyn Culnane
- The Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
| | - Jane Delaney
- Speech Pathology Australia, Melbourne, VIC, Australia
| | | | - Valsamma Eapen
- South Western Sydney Local Health District and Ingham Institute for Applied Medical Research, UNSW Sydney, Liverpool, NSW, Australia
| | | | - Daryl Efron
- Murdoch Children’s Research Institute, Parkville Vic, Australia
- The Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Tatjana Ewais
- Faculty of Medicine, University of Queensland, Herston, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia
| | - Ingrid Garner
- ADHD Guideline Development Group, Melbourne, VIC, Australia
| | - Michael Gathercole
- Youth Justice, Department of Community and Justice, Grafton, NSW, Australia
| | - Karuppiah Jagadheesan
- NWAMHS–North West Area Mental Health Services, Melbourne, VIC, Australia
- Bi-National ADHD Network Committee, RANZCP - Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
- Swinburne University, Melbourne, VIC, Australia
| | - Laura Jobson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - John Kramer
- ADHD, ASD and Neurodiversity Special Interest Group, Faculty of Special Interests, RACGP
- Rural Medical School, UNSW Medicine & Health, Coffs Harbour, NSW, Australia
| | - Martha Mack
- Applied Neuroscience Society of Australasia (ANSA)
| | - Marie Misso
- The Knowledge Synthesis Lab, Melbourne, VIC, Australia
| | - Cammi Murrup-Stewart
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | | | - Emma Sciberras
- Murdoch Children’s Research Institute, Parkville Vic, Australia
- School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Bruce Singh
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Renee Testa
- Department of Mental Health, Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Psychology, Monash University, Melbourne, VIC, Australia
| | - Lisa Vale
- Occupational Therapy Australia, Splash Paediatric Therapy, Melbourne, VIC, Australia
| | - Alyssa Weirman
- ADHD Guideline Development Group, Melbourne, VIC, Australia
| | - Edward Petch
- Hakea Prison, Department of Justice, Perth, WA, Australia
- University of Western Australia, Perth, WA, Australia
| | - Katrina Williams
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
- Monash Children’s Hospital, Clayton, VIC, Australia
| | - Mark Bellgrove
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
- AADPA Australian ADHD Professionals Association, Melbourne, VIC, Australia
| |
Collapse
|
4
|
Sekharan L, Jagadheesan K, Danivas V, Itrat Q, Lakra V. Community mental health services: Access for acute psychiatric care during the COVID-19 lockdown. J Affect Disord 2022; 311:371-372. [PMID: 35594976 PMCID: PMC9112614 DOI: 10.1016/j.jad.2022.05.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/12/2022] [Indexed: 10/25/2022]
Affiliation(s)
- Lokesh Sekharan
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Karuppiah Jagadheesan
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia; Department of Psychiatry, University of Melbourne, Australia.
| | - Vijay Danivas
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Quratulain Itrat
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Vinay Lakra
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia,Department of Psychiatry, University of Melbourne, Australia
| |
Collapse
|
5
|
Melnikoff E, Thomas Johnson E, Walker F, Itrat Q, Jagadheesan K. Prolonged and severe post-electroconvulsive therapy delirium with concurrent clozapine therapy. Aust N Z J Psychiatry 2022; 56:727. [PMID: 34465233 DOI: 10.1177/00048674211044098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Eliza Melnikoff
- North West Area Mental Health Services, Melbourne Health, Melbourne, VIC, Australia.,Broadmeadows Hospital, Broadmeadows, VIC, Australia
| | - Evan Thomas Johnson
- North West Area Mental Health Services, Melbourne Health, Melbourne, VIC, Australia
| | - Frances Walker
- North West Area Mental Health Services, Melbourne Health, Melbourne, VIC, Australia
| | - Quratulain Itrat
- North West Area Mental Health Services, Melbourne Health, Melbourne, VIC, Australia
| | - Karuppiah Jagadheesan
- North West Area Mental Health Services, Melbourne Health, Melbourne, VIC, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
6
|
Jagadheesan K, Lakra V. Capacity, consent and electroconvulsive therapy: What is the next step forward? Aust N Z J Psychiatry 2022; 56:575. [PMID: 34320848 DOI: 10.1177/00048674211036347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Karuppiah Jagadheesan
- Broadmeadows Inpatient Psychiatry Unit, North West Area Mental Health Service, Broadmeadows Coburg, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Vinay Lakra
- Broadmeadows Inpatient Psychiatry Unit, North West Area Mental Health Service, Broadmeadows Coburg, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
7
|
Kodancha PG, Deva G, Jagadheesan K. Self-immolation in borderline personality disorder: A cultural perspective. Aust N Z J Psychiatry 2022; 56:573-574. [PMID: 34414794 DOI: 10.1177/00048674211037550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Gaurav Deva
- North West Area Mental Health Services, Melbourne Health, Broadmeadows, VIC, Australia
| | - Karuppiah Jagadheesan
- North West Area Mental Health Services, Melbourne Health, Broadmeadows, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
8
|
Rego T, Hapuarachchi S, Jambon J, Jagadheesan K, Coulson B. Electroconvulsive therapy during COVID-19: A case report of a new treatment protocol for older adults on maintenance treatment. Aust N Z J Psychiatry 2022; 56:575-576. [PMID: 34344173 DOI: 10.1177/00048674211036362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Thomas Rego
- NorthWestern Mental Health, Melbourne Health, Broadmeadows, VIC, Australia.,Academic Unit of Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Sameera Hapuarachchi
- NorthWestern Mental Health, Melbourne Health, Broadmeadows, VIC, Australia.,Department of Geriatrics, Western Health, St. Albans, VIC, Australia
| | - Julie Jambon
- NorthWestern Mental Health, Melbourne Health, Broadmeadows, VIC, Australia
| | | | - Brett Coulson
- NorthWestern Mental Health, Melbourne Health, Broadmeadows, VIC, Australia.,Academic Unit of Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
9
|
Walker F, Baric A, Sekharan L, James E, Farook F, Itrat Q, Jagadheesan K. Anaesthetic safety with undisclosed substance misuse during electroconvulsive therapy. Australas Psychiatry 2022; 30:278-279. [PMID: 35073783 DOI: 10.1177/10398562211057076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
10
|
Abstract
OBJECTIVES We compared the quality of the written informed consent forms for electroconvulsive therapy (ECT) in Australian jurisdictions. METHOD For this comparative audit-type study, a checklist was developed to compare informed consent forms from different jurisdictions. The main information sources for consent forms were government health department websites and Google. The directors of clinical services were contacted if a consent form was not available through a web source. RESULTS Majority of the informed consent forms covered information about ECT, general anaesthesia and alternative treatments, supports available for decision making, and a reference to the right to withdraw consent. Missing information affected information areas such as likely outcome if no ECT, lack of guaranteed response and cultural and linguistic supports. CONCLUSIONS A standardised consent form that can be used across all jurisdictions can help improve the ECT practice.
Collapse
Affiliation(s)
- Karuppiah Jagadheesan
- Consultant psychiatrist and ECT Director, North West Area Mental Health Service, Coburg, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Frances Walker
- North West Area Mental Health Service, Coburg, VIC, Australia
| | - Vinay Lakra
- North West Area Mental Health Service, Coburg, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
11
|
Abstract
OBJECTIVE We investigated the nature of patients presenting to an emergency department (ED) during the first lockdown in Melbourne. METHOD This study compared adult patients in the North West Area Mental Health Service catchment area who presented to the local ED during the lockdown (16 March-12 May 2020) and the control (16 March-12 May 2019) periods. RESULTS The control and lockdown periods included 321 and 332 patients, respectively. Compared to the control period, patients with non-English speaking backgrounds and presenting complaints of suicidal behaviour were lower, whereas patients with anxiety symptoms and needing compulsory assessments were higher in the lockdown period. Diagnostically, the lockdown period included more patients with anxiety disorders, substance use disorders and psychotic disorders. CONCLUSIONS ED access for acute psychiatric care can vary depending upon certain patient characteristics during lockdowns.
Collapse
Affiliation(s)
- Karuppiah Jagadheesan
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Australia
| | - Vijay Danivas
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Annie Itrat
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Vinay Lakra
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Australia
| |
Collapse
|
12
|
Sekharan L, Jagadheesan K, Das P, Lakra V, West K, Baldwin M. Short-term and 1-year outcome of patients' with borderline personality admitted to a short-term recovery-oriented residential service. Australas Psychiatry 2021; 29:581-585. [PMID: 33026842 DOI: 10.1177/1039856220961646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Given the paucity of literature, this study investigated whether a prevention and recovery care (PARC) service supported recovery in patients with borderline personality disorder (BPD). METHOD This retrospective study included patients with BPD who had their first (index) admission to North West PARC between 2011 and 2016. Patient medical records and the state-wide database were the sources of information. RESULTS Of the 67 patients included, over 70% attended group activities. All patients achieved their recovery goals, either fully or partially. Compared to admission, the frequency of substance use and the Health of the Nation Outcome Scale (HoNOS) scores at discharge were significantly less. A significantly smaller number of patients needed inpatient treatment during the 12 months following their PARC admission. CONCLUSION The PARC service appears to promote clinical and psychosocial recovery in patients with BPD.
Collapse
Affiliation(s)
| | | | - Partha Das
- North West Area Mental Health Service, Melbourne, Australia.,The University of Melbourne, Melbourne, Australia
| | - Vinay Lakra
- North West Area Mental Health Service, Melbourne, Australia
| | - Kim West
- North West Area Mental Health Service, Melbourne, Australia
| | | |
Collapse
|
13
|
Affiliation(s)
- Edith Chau
- NWMH, Psychiatry Department, Level 1N Royal Melbourne Hospital, Parkville, VIC, Australia
| | | |
Collapse
|
14
|
Itrat A, Jagadheesan K, Danivas V, Lakra V. Comments on a comparative study of access to inpatient psychiatric treatment in a public mental health service in Melbourne during COVID-19. Indian J Psychiatry 2021; 63:622. [PMID: 35136269 PMCID: PMC8793713 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_888_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/01/2021] [Accepted: 11/01/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Annie Itrat
- North West Area Mental Health Service, Broadmeadows, Australia
| | - Karuppiah Jagadheesan
- North West Area Mental Health Service, Broadmeadows, Australia.,Department of Psychiatry, The University of Melbourne, Australia. E-mail:
| | - Vijay Danivas
- North West Area Mental Health Service, Broadmeadows, Australia
| | - Vinay Lakra
- North West Area Mental Health Service, Broadmeadows, Australia.,Department of Psychiatry, The University of Melbourne, Australia. E-mail:
| |
Collapse
|
15
|
Jagadheesan K, Tipirneni S. Pharmacogenetic testing and antidepressants: A clinical perspective. J Affect Disord 2021; 294:448-449. [PMID: 34325163 DOI: 10.1016/j.jad.2021.07.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Karuppiah Jagadheesan
- Northpark Private Hospital, Bundoora, VIC 3083, Australia; North West Area Mental Health Service, Broadmeadows, VIC 3047, Australia; The University of Melbourne, Melbourne, Australia.
| | | |
Collapse
|
16
|
Abstract
OBJECTIVES (i) to describe the operational strategies implemented to practise electroconvulsive therapy (ECT) safely, and (ii) to explore the effect of the lockdown and operational strategies on the characteristics of patients who received ECT during the initial 6 months of the COVID-19 lockdown. METHODS At first, the operational strategies that were implemented at the Broadmeadows ECT suite were summarised. Subsequently, the characteristics of patients who received ECT in the lockdown period (16 March-16 September 2020) and in the comparison period (16 March-16 September 2019) were compared. RESULTS Many safety measures were implemented, and there was no COVID-19 infection among mental health staff and patients. In the lockdown period, the number of patients (23.9%) and the total number of ECTs (29.4%) were less. This pattern was more prominent among the aged patients. CONCLUSION Safe practices are essential to provide ECT during lockdowns even when the community transmission of COVID-19 is high.
Collapse
Affiliation(s)
- Karuppiah Jagadheesan
- North West Area Mental Health Service, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
| | - Frances Walker
- North West Area Mental Health Service, Melbourne, Victoria, Australia
| | - Vijay Danivas
- North West Area Mental Health Service, Melbourne, Victoria, Australia
| | - Quratulain Itrat
- North West Area Mental Health Service, Melbourne, Victoria, Australia
| | - Vinay Lakra
- North West Area Mental Health Service, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
17
|
Jagadheesan K, Danivas V, Itrat Q, Shekaran L, Lakra V. A 6-month study on the pattern of emergency department presentations for schizophrenia and other psychotic disorders during COVID-19 lockdown. Psychiatry Res 2021; 303:114081. [PMID: 34246006 PMCID: PMC8520318 DOI: 10.1016/j.psychres.2021.114081] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/14/2021] [Accepted: 06/25/2021] [Indexed: 01/08/2023]
Abstract
This study investigated the characteristics of patients with schizophrenia and other psychotic disorders presenting to emergency departments (ED) for psychiatric treatment during the first six months of the COVID-19 lockdown in Melbourne. This cross-sectional data-base study included adult patients in the North West Area Mental Health Service's catchment area who had visited two emergency departments (EDs) during the study period (March 16-September 16, 2020) and the control period (March 16-September 16, 2019). Compared to the control period (n = 467), the lockdown period (n = 451) had a 6.8% more psychotic disorders. This increase was particularly noted for schizophrenia and acute transient psychosis. In a sub-analysis of psychotic disorder group alone, compared to the control period, more patients were discharged to the community in the lockdown period. In another sub-analysis, compared to the mood disorder group, psychotic disorder group included more patients in 26-35 and 46-55 age groups, men, emergency triage category, and hospital admissions and higher mean duration of ED stay in the lockdown period. Overall, patients with psychotic disorders had increased ED presentations and appeared to be in an emergency state when they present to ED during the lockdown.
Collapse
Affiliation(s)
- Karuppiah Jagadheesan
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia; Department of Psychiatry, University of Melbourne, Australia.
| | - Vijay Danivas
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Quratulain Itrat
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Lokesh Shekaran
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Vinay Lakra
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia; Department of Psychiatry, University of Melbourne, Australia
| |
Collapse
|
18
|
Das P, Jagadheesan K, Lakra V. The Mental Health Act (MHA) 2014 and the use of electroconvulsive therapy (ECT) in Victoria. Australas Psychiatry 2021; 29:367-368. [PMID: 33167662 DOI: 10.1177/1039856220970074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
19
|
Jagadheesan K, Danivas V, Itrat Q, Sekharan L, Lakra APV. COVID-19 and psychiatric admissions: An observational study of the first six months of lockdown in Melbourne. Psychiatry Res 2021; 300:113902. [PMID: 33799197 PMCID: PMC7986313 DOI: 10.1016/j.psychres.2021.113902] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/21/2021] [Indexed: 11/21/2022]
Abstract
Research on the effect of a prolonged lockdown on inpatient admissions is limited. In this background, this study was planned, and it included patients admitted to inpatient units of a large mental health network in Melbourne during the lockdown (March 16-September 16, 2020) and a similar time period in 2019. The results showed a 12% decrease in admissions. The lockdown period included patients with lower mean age and more patients with never married status, higher education status, students and patients with home duties, and certain psychiatric diagnoses. Overall, the patients needing inpatient treatment during a prolonged lockdown are different.
Collapse
Affiliation(s)
- Karuppiah Jagadheesan
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia; Department of Psychiatry, University of Melbourne, Australia.
| | - Vijay Danivas
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Quratulain Itrat
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Lokesh Sekharan
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Assoc Prof Vinay Lakra
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia,Department of Psychiatry, University of Melbourne, Australia
| |
Collapse
|
20
|
Forbes M, Somasundaram A, Jagadheesan K, Stuckey S. When should we image our patients? Appropriate use of imaging in inpatient psychiatry. Australas Psychiatry 2021; 29:286-288. [PMID: 32586111 DOI: 10.1177/1039856220934313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Injudicious use of medical imaging may be associated with harm to patients and increased downstream healthcare costs. Guidance on the use of imaging in common psychiatric inpatient scenarios is inconsistent or absent. This paper explores three common clinical scenarios facing adult psychiatrists and provides guidance about the appropriate use of imaging. CONCLUSION Psychiatrists and their junior colleagues would benefit from considering both pre- and post-test probability in each presentation.
Collapse
|
21
|
Itrat A, Jagadheesan K, Danivas V, Lakra V. A comparative study of access to inpatient psychiatric treatment in a public mental health service in Melbourne during COVID-19. Indian J Psychiatry 2020; 62:S454-S458. [PMID: 33227079 PMCID: PMC7659780 DOI: 10.4103/psychiatry.indianjpsychiatry_852_20] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Given the paucity of research on how COVID-19 pandemic-associated lockdowns have affected the access to inpatient treatment, the present study was carried out. AIMS This study aims to describe (1) the characteristics of patients who accessed inpatient treatment, (2) the length of inpatient stay and readmissions, and (3) the quality and safety of care as indicated by the type of admission (voluntary/compulsory) and seclusion use during the lockdown period. MATERIALS AND METHODS For this comparative database study conducted at North West Area Mental Health Service, the study group included patients who had an admission between March 16, 2020 (starting of social distancing measures in Victoria) and May 12, 2020 (when easing [Stage 1] of social restrictions started). The control group included patients admitted between March 16, 2019, and May 12, 2019. The hospital databases were sources of information. RESULTS The study and control groups included 104 and 109 patients, respectively. Compared to the control group, the study group had significantly more patients with separated relationship status, a lower number of severe mental illnesses (SMIs), a higher number of substance use disorders, and lower readmissions. A subanalysis within the lockdown period showed more voluntary admissions in the initial phase whereas more compulsory admissions in the later phase at trend significance. CONCLUSION Patients with a separated relationship status and a substance use disorder sought inpatient treatment more than others. Aside from exploring the reasons for these findings, it is also important to investigate why SMIs and readmissions decreased during the lockdown period through further studies.
Collapse
Affiliation(s)
- Annie Itrat
- North West Area Mental Health Service and The University of Melbourne, Melbourne, Australia
| | - Karuppiah Jagadheesan
- North West Area Mental Health Service and The University of Melbourne, Melbourne, Australia
| | - Vijay Danivas
- North West Area Mental Health Service and The University of Melbourne, Melbourne, Australia
| | - Vinay Lakra
- North West Area Mental Health Service and The University of Melbourne, Melbourne, Australia
| |
Collapse
|
22
|
Das P, Jagadheesan K, Walker F, Lakra V, Lautenschlager NT, Ferraro A, Rudolph D. Is There a Change in Electroconvulsive Therapy Practice Following the New Mental Health Act 2014 in Victoria?: A Study at a Metropolitan Mental Health Service. J ECT 2019; 35:245-250. [PMID: 31764447 DOI: 10.1097/yct.0000000000000581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The main objective of our study was to examine whether there has been any change to electroconvulsive therapy (ECT) practice since the new Mental Health Act 2014 (MHA) in a public metropolitan mental health service in Victoria. METHODS This retrospective study examined any change in ECT rate following the new MHA. We compared sociodemographic, clinical, and ECT-related variables for patients treated before (July 1, 2013, and June 30, 2014) and after (1st July 2014 and the 30th June 2015) the new MHA. RESULTS A reduction of 11.15% in ECT use per 1000 admissions and 16.4% in ECT use per 100,000 persons was observed subsequent to the new MHA. Hospital legal status at admission positively predicted the chance of starting ECT treatment under involuntary consent. Hospital legal status at admission and discharge, history of involuntary ECT, and final Clinical Global Impression-Severity scores positively predicted, but the year of treatment negatively predicted the chance of completing ECT treatment under involuntary consent. CONCLUSIONS The new MHA appeared to have been associated with reduced ECT use and lower rate of completing ECT under involuntary consent.
Collapse
Affiliation(s)
- Partha Das
- From the North West Area Mental Health Service, Broadmeadows
- The University of Melbourne, Melbourne
| | | | - Frances Walker
- From the North West Area Mental Health Service, Broadmeadows
| | - Vinay Lakra
- Clinical Services, North West Area Mental Health Service, Coburg
| | | | - Angelo Ferraro
- APMHP North Western Mental Health, Broadmeadows
- Aged Care Inpatient Unit, APMHP North Western Mental Health, Broadmeadows, Australia
| | | |
Collapse
|
23
|
Abstract
Near-death experiences (NDEs) include a set of subjective experiences encountered by people who were close to death or were faced with life-threatening situations. Reports have suggested that the phenomenology of NDE might differ across cultures. This article is aimed at providing an updated phenomenological perspective by comparing NDEs in a cross-cultural context. We compared the various descriptions of NDEs from a phenomenological perspective. There were similarities between particular cultures, which differed from typical western European experiences. This article concludes that although there are common themes, there are also reported differences in NDEs. The variability across cultures is most likely to be due to our interpretation and verbalizing of such esoteric events through the filters of language, cultural experiences, religion, education and their influence on our belief systems either shedding influence as an individual variable or more often perhaps by their rich interplay between these factors.
Collapse
Affiliation(s)
- John Belanti
- Broadmeadows Adult Community Mental Health, Broadmeadows VIC 3407, Australia.
| | | | | |
Collapse
|
24
|
Abstract
BACKGROUND Given the paucity of quantitative EEG studies using coherence measures to understand the electrophysiological functional integrity of sub-cortical structures in obsessive-compulsive disorder, the current study was carried out. METHODS We obtained EEG coherence values for 20 adult OCD patients (10 males; 10 females) and 19 appropriately matched healthy controls across delta (0.5-3.5 Hz), theta (4-7.5 Hz), alpha (8-12 Hz), beta1 (12.5-20 Hz) and beta2 (20.5-30 Hz) bands. As coherence between distant brain regions reflects physiological activities at sub-cortical neural networks, we chose EEG channels at four distant brain regions - anterior interhemispheric, posterior interhemispheric, fronto-temporal and fronto-occipital. RESULTS In comparison to controls we found significant increase of theta band EEG coherence in the fronto-occipital region in OCD patients (P = 0.045) which did not correlate significantly with either medication status or disease severity. CONCLUSION This EEG coherence study that suggests hyperactivity at subcortical circuitry in OCD patients is in agreement with existing neuro-imaging findings. Furthermore, this finding provides external validity for sub-cortical dysfunction hypothesis of OCD.
Collapse
Affiliation(s)
- Pushpal Desarkar
- Centre for Cognitive Neuroscience, Central Institute of Psychiatry, Ranchi, Jharkhand, India.
| | | | | | | |
Collapse
|
25
|
Lusicic A, Jagadheesan K. Sertraline versus venlafaxine XR in major depressive disorder. J Clin Psychiatry 2007; 68:1618-9; author reply 1619. [PMID: 17960983 DOI: 10.4088/jcp.v68n1023c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
26
|
|
27
|
|
28
|
|
29
|
Jagadheesan K, Muirhead D. Possible manic potential of buprenorphine. Aust N Z J Psychiatry 2004; 38:560-1. [PMID: 15255831 DOI: 10.1111/j.1440-1614.2004.01411.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
30
|
|
31
|
|
32
|
|
33
|
|
34
|
Thakur A, Jagadheesan K, Sinha VK. Psychopathological dimensions in childhood and adolescent psychoses: a confirmatory factor analytical study. Psychopathology 2003; 36:190-4. [PMID: 14504452 DOI: 10.1159/000072788] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2002] [Accepted: 01/09/2003] [Indexed: 11/19/2022]
Abstract
The present study explored psychopathological dimensions in psychoses of children and adolescents and the distribution of demographic and clinical variables across different psychopathological domains. This study included 101 consecutive patients aged 6-18 years who had a DSM-IV psychotic disorder (schizophrenia and related disorders or mood disorders). Exclusion criteria included presence of organicity, substance use disorders, and any other childhood disorder. Psychopathology was assessed with Scales for Assessment of Positive and Negative Symptoms. Analysis revealed a four-factor model comprising primary negative, secondary negative, manic and paranoid factors. Patients were regrouped into one of the four factors based on their symptomatology. Patients in these four groups differed in education and age of onset and duration of illness. This study confirmed the existence of a factor structure in psychoses of children and adolescents.
Collapse
Affiliation(s)
- Anupam Thakur
- Central Institute of Psychiatry, Kanke (PO), Ranchi-834 006, Jharkhand, India.
| | | | | |
Collapse
|
35
|
Jagadheesan K, Duggal HS, Gupta SC, Basu S, Ranjan S, Sandil R, Akhtar S, Nizamie SH. Acute antimanic efficacy and safety of intravenous valproate loading therapy: an open-label study. Neuropsychobiology 2003; 47:90-3. [PMID: 12707491 DOI: 10.1159/000070015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This open-label study investigated whether acute antimanic effects and safety of intravenous valproate loading therapy is superior to oral valproate loading. Eighteen patients with DSM-IV diagnosis of either bipolar affective disorder or schizomania who met the study criteria were recruited (9 in the intravenous and 9 in the oral valproate group). Psychopathology was assessed with the scale for manic and mixed states on days 0 and 4. A checklist was used for the assessment of side effects. The results showed about 36% reduction in total mean manic scores with intravenous valproate loading; however, statistically, the degree of reduction in manic scores was comparable between the groups. A nonsignificant increase in the rate of adverse events was noted in the intravenous group. Despite its limitations, this study suggests that acute antimanic effects of both intravenous and oral valproate loading are comparable.
Collapse
|
36
|
Abstract
OBJECTIVE To investigate the incidence and phenomenology of catatonia in a child and adolescent population. METHOD Children and adolescents who had attended a paediatric psychiatric outpatient clinic between April and July 2001 were examined for catatonic signs with a formal catatonia rating scale, and patients who had at least two catatonic signs were included. RESULTS Eleven patients met the criteria (5.5% of the entire sample and 17.7% of the patients with affective and nonaffective psychotic disorder); of them eight had an affective disorder and three a nonaffective disorder. The mean catatonic scores were significantly high for males and patients with mental retardation. CONCLUSION This study shows that catatonia occurs in children and adolescents. Further studies are essential to clarify the distribution of catatonia across various diagnoses and the outcome of paediatric catatonia.
Collapse
Affiliation(s)
- Anupam Thakur
- Central Institute of Psychiatry, Kanke (Po), Ranchi-834 006, Jharkhand, India.
| | | | | | | |
Collapse
|
37
|
|
38
|
Abstract
BACKGROUND This case-control study investigated both the risk factors and outcome of mood disorders in epilepsy. METHODS For this study, 44 patients with both epilepsy and a mood disorder (study group) were compared with 44 randomly selected patients of epilepsy without a mood disorder (control group). Psychiatric diagnosis was made as per ICD-10 Diagnostic Criteria for Research (ICD-10 DCR). International classification for seizure types (1981) was used for classification of seizure types. RESULTS Of the patients in the study group, a majority were educated up to at least primary level, had later onset of seizures, longer duration of epilepsy and cluster attacks. The outcome of mood disorders in epilepsy was found good in most. CONCLUSIONS Educated patients who develop epilepsy at a later age and patients with poorly controlled epilepsy are more likely to experience mood disorders. In most patients with epilepsy, mood disorders remit completely; notably, in some patients affective symptoms resolve spontaneously.
Collapse
Affiliation(s)
- K Jagadheesan
- Central Institute of Psychiatry, Kanke (PO), Ranchi-834006, India
| | | | | |
Collapse
|
39
|
|
40
|
Jayakumar C, Jagadheesan K, Verma AN. Caregiver'S burden : a comparison between obsessive compulsive disorder and schizophrenia. Indian J Psychiatry 2002; 44:337-42. [PMID: 21206596 PMCID: PMC2955303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The present study compared burden of care between the key relatives of patients with obsessive compulsive disorder (OCD) and schizophrenia. For this study, consecutive key relatives of patients with either OCD (n=30) or schizophrenia (n=41) were evaluated with 40-item burden assessment schedule (BAS). In comparison with schizophrenia group, caregivers in OCD group had significantly high mean scores for the domains, spouse-related factor and caregiver's strategy of BAS. The degree of burden, evidenced by mean scores, was comparable between groups for other domains of BAS. Spouses and unemployed caregivers in OCD group had significantly elevated mean total burden scores. The present findings suggest that caregiver's burden imposed by OCD is either excess or nearly comparable to that of schizophrenia.
Collapse
Affiliation(s)
- C Jayakumar
- C. JAYAKUMAR., M.Phil PSW, II-Year trainee, Dept. of Psychiatry Social Work, Central Institute of Psychiatry, Ranchi-834006
| | | | | |
Collapse
|
41
|
Duggal HS, Jagadheesan K, Nizamie HS. 'Internet delusion' responsive to cognitive therapy. Indian J Psychiatry 2002; 44:293-6. [PMID: 21206587 PMCID: PMC2954403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
Delusions are known to be influenced by the popular media, the sociopolitical undercurrents and also by the scientific innovations. Internet is one such modern communication tool, which can easily be incorporated into the delusional system of patients by virtue of its semblance to some psychopathological phenomena. We describe a patient with paranoid schizophrenia who developed a delusion about the Internet controlling him but showed a good response to cognitive therapy.
Collapse
Affiliation(s)
- Harpreet S Duggal
- HARPREET S. DUGGAL, M.D., D.P.M., Resident, Central Institute of Psychiatry, Kanke, Ranchi - 834006
| | | | | |
Collapse
|
42
|
Affiliation(s)
- C Jayakumar
- Central Institute of Psychiatry, Ranchi-Jharkhand, India
| | | | | |
Collapse
|
43
|
|
44
|
Duggal HS, Jagadheesan K, Gupta S, Basu S, Akhtar S, Nizamie HS. Intravenous valproate: a new perspective in the treatment of manic symptoms. Indian J Psychiatry 2002; 44:173-6. [PMID: 21206565 PMCID: PMC2954347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Over the last few years, the use of valproate in psychiatry has increased considerably. With the advent of oral loading dose strategy, its role in rapid treatment of acute mania has been demonstrated. The intravenous formulation of valproate, while retaining the rapidity of action of oral loading, also avoids some of the adverse effects of the oral preparation. Moreover, reports are pouring in that intravenous valproate loading may be more efficacious than oral valproate loading in the treatment of acute mania. We report two patients whose manic symptoms showed a dramatic response to intravenous valproate without adverse effects. The pharmacology of intravenous valproate and its clinical relevance to psychiatry are discussed.
Collapse
Affiliation(s)
- Harpreet S Duggal
- HARPREET S. DUGGAL, D.P.M., Resident, Central Institute of Psychiatry, Kanke. Ranchi-834006.
| | | | | | | | | | | |
Collapse
|
45
|
|
46
|
|
47
|
Jagadheesan K, Nizamie HS, Thakur A. Catatonia in obsessive compulsive disorder. Indian J Psychiatry 2002; 44:179-82. [PMID: 21206567 PMCID: PMC2954349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Catatonia occurs in a wide range of neuropsychiatric conditions. Among the psychiatric disorders, occurrence of catatonia has rarely been documented in obsessive-complsive disorder. Given the paucity of reports, we report two cases of obsessive compulsive disorder that presented as catatonia.
Collapse
Affiliation(s)
- K Jagadheesan
- K. JAGADHEESAN, M.D., Senior Resident, Central Institute of Psychiatry, Kanke, Ranchi-834006.
| | | | | |
Collapse
|
48
|
|
49
|
|
50
|
|