Abhijit Nadkarni

Abhijit Nadkarni
London School of Hygiene and Tropical Medicine | LSHTM · Department of Population Health

MBBS, DPM, MRCPsych, MSc, PhD

About

102
Publications
17,835
Reads
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1,408
Citations
Additional affiliations
January 2015 - present
Sangath
Position
  • Managing Director
December 2011 - present
Sangath
Position
  • Research Associate
September 2011 - February 2015
London School of Hygiene and Tropical Medicine
Position
  • Research Associate

Publications

Publications (102)
Article
Full-text available
Global alcohol consumption and harmful use of alcohol is projected to increase in the coming decades, and most of the increase will occur in low- and middle-income countries (LMICs); which calls for cost-effective measures to reduce alcohol exposure in these countries. One such evidence based measure is screening and brief intervention (BI) for alc...
Article
Sub‐Saharan Africa (SSA) has the fastest growing adolescent population in the world. In addition to developmental changes, adolescents in SSA face health and socioeconomic challenges that increase their vulnerability to mental ill‐health. This paper is a narrative review of adolescent mental health (AMH) in SSA with a focus on past achievements, cu...
Article
Full-text available
Background Randomised controlled trials (RCTs) have been increasingly used to test the effectiveness of mental health and psychosocial (MHPSS) interventions for populations affected by humanitarian crises. Process evaluations are often integrated within RCTs of psychological interventions to investigate the implementation of the intervention, the i...
Article
'Indigenous peoples' across the globe suffer a disproportionate burden of mental illness. However, this burden is not fully explored in India despite having the second largest absolute concentration of indigenous peoples in the world. We did a secondary analysis of data from a cross-sectional survey in indigenous populations from the Nilgiri Biosph...
Article
Full-text available
Objective To evaluate the feasibility and acceptability of a mobile-based brief intervention (BI), generate preliminary estimates of the impact of the BI and fine-tune the procedures for a definitive randomised controlled trial. Design Parallel three-arm single-blind individually randomised controlled pilot trial. Eligible and consenting participa...
Article
Full-text available
Background Tele-psychiatry is an increasingly acceptable and feasible platform to deliver mental health care with the potential to increase access to care in low-resource settings. We aim to examine the acceptability and preliminary impact of the delivery of assisted tele-psychiatry services in primary healthcare settings in Goa, India. Methods Be...
Article
Full-text available
Introduction: Stigma towards alcohol use disorders is prevalent in India and can lead to social exclusion and hamper treatment access and outcomes. Family members of individuals with dependent drinking are often their primary caregivers and play a key role in decisions around help-seeking, treatment and recovery. The nature and role of stigma in c...
Article
Full-text available
Background Alcohol use is typically established during adolescence and initiation of use at a young age poses risks for short- and long-term health and social outcomes. However, there is limited understanding of the onset, progression and impact of alcohol use among adolescents in India. The aim of this review is to synthesise the evidence about pr...
Article
Only around 50-75% of individuals fully understand the various aspects of informed consent in research. The aim of our study was to examine whether supplementing the conventional paper-based informed consent process with an audiovisual aid improves participants' understanding of the informed consent process and the information conveyed to them. Par...
Article
Full-text available
Background We investigated the feasibility, acceptability, safety, and preliminary effectiveness of the Counselling for Alcohol Problems (CAP) psychological intervention delivered by non-specialist health workers (NSHW) to participants with alcohol use disorder (AUD) and comorbid depression in primary care. Methods We used data from a single blind...
Article
Full-text available
A significant treatment gap exists for mental illnesses across the world, particularly in low- and middle-income countries (LMICs). Task-sharing, a potentially scalable strategy to bridge the treatment gap, has been shown to be feasible and effective for the treatment of a range of mental illnesses. However, there is a lack of research examining la...
Article
Problem Management+ (PM+) is a transdiagnostic intervention and addresses symptoms across multiple common mental disorders. It does not yet include strategies to reduce alcohol misuse which is a considerable problem among conflict-affected men, and part of the co-morbidity spectrum. In this commentary, we describe the need to address symptoms of co...
Article
Full-text available
The influence of husband's alcohol consumption and that of women's empowerment has been largely studied separately in relation to the intimate partner violence (IPV) faced by women, which has hindered a nuanced understanding of gender-based violence in India. This study aimed to understand how husbands' alcohol consumption shapes the relationship b...
Article
Background The treatment gap for alcohol use disorders (AUD) in India is the highest among all mental health and substance use disorders. Despite evidence of the cost effectiveness of brief interventions (BIs) for hazardous drinking, implementation in low- and middle-income countries (LMICs) is rare due to several human resource–related barriers. T...
Article
Background Training non-specialist health workers (NSHWs) at scale is a major barrier to increasing the coverage of depression care in India. This trial will test the effectiveness of two forms of digital training compared to conventional face-to-face training in changing the competence of NSHWs to deliver a brief evidence-based psychological treat...
Article
Background: People with severe mental illness (SMI) die prematurely. They also have disproportionately high burden of diabetes, dyslipidemia, and obesity, which is further compounded by unhealthy lifestyle such as sedentary behavior and substance use. Consequently, there is a high prevalence of metabolic syndrome (MetS) in this population. MetS has...
Article
Qualitative research is increasingly being integrated within the development and evaluation phases of trials of complex health interventions. Qualitative research can complement effectiveness data and provide insights around how context and implementation impact the results of the trial and to what extent interventions fit implementation contexts a...
Article
Internet gaming disorder (IGD) is a condition in which the individual is preoccupied with playing online video games and unable to regulate this behaviour, resulting in adverse physical and psychological consequences. Although there is some debate about whether IGD is an addiction or a coping mechanism, global evidence indicates that the condition...
Technical Report
Full-text available
The State of the Tropics Report analyses a range of environmental, social and economic indicators to answer the question - is life getting better in the Tropics? The analysis shines a bright light on a variety of key issues and provides a foundation for policy makers, geopolitical analysts and other stakeholders to examine in greater detail the tro...
Article
Introduction and Aims Of the Indian population, 2.7% have alcohol dependence, the most severe of alcohol use disorders. Alcohol use disorders have previously been found to be correlated with a range of negative economic outcomes, but dependent drinking has yet to be causally identified as a poverty trap. We use qualitative data as the first step to...
Article
In response to the COVID-19 pandemic, as with other countries across the world, the Central and State Governments of India initiated several measures to slow down the spread of the virus and to ‘flatten the curve’. One such measure was a ‘total lockdown’ for several weeks across the country. A complex and unexpected outcome of the lockdown which ha...
Conference Paper
Hazardous drinking (HD) is a major public health problem in India. However, healthcare access is limited by the shortage of healthcare professionals. Extensive global evidence demonstrates the effectiveness of technology-delivered BIs in reducing alcohol consumption. Our study aims to increase healthcare access for HD, by designing a contextually-a...
Article
Despite the increasing burden of alcohol dependence, treatment resources in low- and middle-income countries such as India, are concentrated in poorly accessible tertiary care facilities. The aim of our study was to examine the feasibility and acceptability of lay health worker delivered home-based packages of care for alcohol dependence. We conduc...
Article
Introduction: The World Health Organization's (WHO) Alcohol Use Disorders Identification Test (AUDIT) is used extensively across the world, with cut-off scores recommended by the WHO. We reviewed the use and validity of AUDIT cut-off scores in low- and middle-income countries as cultural contexts are expected to influence the detection of alcohol...
Article
Full-text available
Aims To examine the feasibility, acceptability, and preliminary cost‐effectiveness of a lay counsellor delivered psychological treatment for men with alcohol dependence in primary care. Design Single‐blind individually randomized trial comparing Counselling for Alcohol Problems [CAP] plus Enhanced Usual Care [EUC]) versus EUC only. Setting Ten pr...
Article
Full-text available
Background: There is a significant evidence gap on gambling in India, where gambling is viewed predominantly through the legal lens. The aim of this study is to determine the prevalence, patterns, and correlates of gambling. Methods: Cross-sectional data from the follow-up assessment in a cohort (n = 1514 men) from India. The following data were...
Article
Full-text available
Background The current study explored the temporal pathways of change within two treatments, the Healthy Activity Program (HAP) for depression and the Counselling for Alcohol Problems (CAP) Program for harmful drinking. Methods The study took place in the context of two parallel randomized controlled trials in Goa, India. N = 50 random participant...
Chapter
The entire range of addictions is increasingly being acknowledged as an area of public health concern. Substance use disorders and behavioral addictions are associated with a range of adverse health, lifestyle, social, and economic outcomes. Despite the availability of evidence-based interventions, low-resource settings are ridden with challenges o...
Article
Full-text available
Introduction The aim of this review is to provide the first consolidation of the policy environment surrounding alcohol-related societal harm in India giving researchers and policy-makers a clearer base for future reforms. This review is also an important adaptation on the scoping review method for policy reviews in low-resource settings that may s...
Article
Full-text available
Community-based mental health services are emphasized in the World Health Organization’s Mental Health Action Plan, the World Bank’s Disease Control Priorities, and the Action Plan of the World Psychiatric Association. There is increasing evidence for effectiveness of mental health interventions delivered by non-specialists in community platforms i...
Article
Introduction: Despite the large burden of a relative's drinking on their family members, the latter's perspectives and experiences are largely neglected. The aims of this article are to assess the coping strategies used by affected family members (AFMs) in Goa, India, and to examine the nature of the support they have for dealing with their drinki...
Article
Alcohol use disorders (AUD) are a significant and growing public health problem in India. However, health services for AUD remain largely confined to large institutions and a significant proportion of people with AUD do not having access to help for their alcohol related problems. One way of changing this status quo is making evidence based psychos...
Article
Aims: To explore the effect of the relatives’ drinking on their family members, and the preliminary impact of the 5-step method intervention on the adverse effect of the relatives’ drinking on their family members. Methods: In-depth interviews were conducted with eligible Affected Family Members (AFMs) (n = 30) to understand the effect of the relat...
Article
Full-text available
Background The Healthy Activity Programme (HAP), a brief behavioural intervention delivered by lay counsellors, enhanced remission over 3 months among primary care attendees with depression in peri-urban and rural settings in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of HAP over 12 mon...
Article
Full-text available
Background Counselling for Alcohol Problems (CAP), a brief intervention delivered by lay counsellors, enhanced remission and abstinence over 3 months among male primary care attendees with harmful drinking in a setting in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of CAP over 12 months,...
Data
Cost-effectiveness acceptability curve: Willingness to pay per remission achieved via counselling for alcohol problems from a health system perspective. (DOCX)
Data
Description of serious adverse events over 12 months by arm. (DOCX)
Data
Mediation results examining patient-reported readiness to change at 3 months on mean standard ethanol consumption at 12 months (n = 151). Beta estimates (β) are unstandardised. Multiple linear regression models controlled for baseline AUDIT score, baseline PHQ-9 score, where the intervention was delivered (primary health centre) and who delivered i...
Data
Interaction effect of readiness to change, expectations of treatment, and drinking severity (AUDIT score) at baseline on the effect of CAP on primary outcomes. (DOCX)
Data
Intervention effect on outcomes at 12 months (complete case analysis and random effects). 1Among those with observed data at 12 months. 2Number of participants for whom AUDIT and Alcohol Timeline Followback were available. 3Including imputed outcome data for those with missing data. 4Analysed with a zero-inflated negative binomial model that fits 2...
Data
Means and 95% CIs for key variables used in mediation analyses. (DOCX)
Data
Study protocol. The effectiveness and cost-effectiveness of lay-counsellor-delivered psychological treatments for harmful and dependent drinking and moderate to severe depression in primary care in India: PREMIUM study protocol for randomised controlled trials. (PDF)
Data
Cost-effectiveness planes: CAP plus EUC compared to EUC alone per recovery achieved. (DOCX)
Data
Secondary outcomes at 12 months. (DOCX)
Data
Baseline characteristics of completers of outcome evaluation and those lost to follow-up. 1Includes those who completed the 3- and 12-month evaluations (n = 305) and those who completed only the 12-month evaluation (n = 11). 2Includes those who completed only the 3-month evaluation (n = 31) and those who dropped out before the 3-month evaluation (n...
Data
Mean costs (2015 international dollars) and QALYs gained per person over 12 months. (DOCX)
Data
Counselling for Alcohol Problems (CAP) manual. (PDF)
Data
Statistical analysis plan for the PREMIUM randomised controlled trials of the effectiveness and cost-effectiveness of lay-counsellor-delivered psychological treatments for harmful and dependent drinking and moderate to severe depression in primary care in India. (DOC)
Data
Cost-effectiveness acceptability curve: Willingness to pay per QALY gained from HAP from a health system perspective. (TIF)
Data
Cost-effectiveness planes: HAP plus EUC compared to EUC per remission achieved. (A) Health system perspective; (B) societal perspective. (TIF)
Data
Comparison of participants who were followed up and those lost to follow-up at 3 and 12 months. (DOCX)
Data
Results of t test and descriptive statistics for change in mean primary outcome score between the 3- and 12-month endpoints by trial arm (complete case n = 438). (DOCX)
Data
Interaction effect of baseline depression severity, sex, length of depression, and expectations of treatment on the effect of HAP plus EUC on scores for depression symptoms (BDI-II outcome). 1Adjusted for PHC as a fixed effect and PHQ-9 baseline score. (DOCX)
Data
Secondary outcomes at 12 months. (DOCX)
Data
Effect of HAP plus EUC on scores for depression symptoms, disability, suicide behaviour, and intimate partner violence over 9 months, based on complete case and random effects. 1Adjusted for PHC as a fixed effect and PHQ-9 baseline score. ***Not previously specified in trials protocol but specified in published analysis plan. #Suicidal thoughts ove...
Data
Statistical analysis plan. (DOC)
Data
Serious adverse events and medication use by arm in the last 3 months. (DOCX)
Data
Mediation results examining the effect of patient-reported activation levels at 3 months on 12-month depression outcomes. *Beta estimates are unstandardised. Multiple linear regression models controlled for baseline PHQ-9 score, participant age, and PHC. *p < 0.05. **p < 0.01. ***p < 0.001. c′, total effect; a × b, indirect effect. (DOCX)
Data
Mean costs (2015 international dollars) and QALYs gained per person over 12 months. (DOCX)
Article
Full-text available
Quantitative evidence about the burden of alcohol use disorders (AUDs) needs to be complemented with a nuanced qualitative understanding of explanatory models to help supplement public health strategies that are too often steeped uncritically in biomedical models. The aim of this study was to identify the role of various factors in the onset and pe...
Article
Full-text available
Aims: The aim of this study was to examine trajectories of Alcohol Use Disorders (AUD) over a 6 year period and compare the bio-psycho-social correlates between these trajectories. Methods: Community-based cohort of 1899 adult men were interviewed in 2006-2008 and 2012-2014. AUD were assessed using the Alcohol Use Disorder Identification Test, a...
Article
Full-text available
Aim: To review the literature on psychosocial interventions for addiction affected family members in Low and Middle Income Countries (LMIC). Methods: A systematic review with a detailed search strategy focussing on psychosocial interventions directed towards people affected by addiction without any gender, year or language specifications was con...
Article
Aims The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item screening questionnaire used to detect alcohol use disorders. The AUDIT has been validated in only two studies in India and although it has been previously used in Goa, India, it has yet to be validated in that setting. In this paper, we aim to report data on the validity of th...
Thesis
Harmful drinking adversely affects the drinkers’ health, social, and occupational functioning, leads to immense societal costs, and causes a significant burden on global health. Despite this, policy makers, and consequently health systems, are disproportionately focused on providing care for dependent drinking, the more severe end of the alcohol us...
Article
Background There have not been many attempts to validate screening measures for common mental disorders (CMD) in low- and middle-income countries. The aim of this study was to examine the criterion validity of the General Health Questionnaire 12 (GHQ-12) in a community-based study from Goa, India. Method Concurrent and convergent validity of the G...
Article
Gambling has been a popular pastime in ancient and colonial India, and continues to be in modern India. Problem gambling is an important public health issue because of its prevalence, increased risk to certain vulnerable groups and its numerous adverse consequences to the gambler, his/her family and the wider society. In this paper, we present an o...
Article
Background: VISHRAM was a community-based mental health programme with the goal of addressing the mental health risk factors for suicide in people from 30 villages in the Amravati district in Vidarbha, central India. We aimed to assess whether implementation of VISHRAM was associated with an increase in the proportion of people with depression who...
Article
: Although structured psychological treatments are recommended as first-line interventions for harmful drinking, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of Counselling for Alcohol Problems (CAP), a brief psychological treat...
Article
Full-text available
Background: Although structured psychological treatments are recommended as first-line interventions for harmful drinking, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of Counselling for Alcohol Problems (CAP), a brief psycholo...
Article
Despite the potential advantages of community detoxification for alcohol dependence, in many countries the available resources are mostly focused on specialist services that are resource-intensive, and often difficult to access because of financial or geographical factors. The aim of this systematic review is to synthesise the existing literature a...