Akshya Vasudev

Akshya Vasudev
The University of Western Ontario | UWO · Department of Psychiatry

MBBS, MD, MRCPsych PG Cert Med Edu

About

92
Publications
11,127
Reads
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929
Citations
Introduction
Akshya Vasudev currently works at the Department of Psychiatry, The University of Western Ontario. Akshya does research in Psychiatry. Their current project is 'Non pharmacological techniques for health and well being'.
Additional affiliations
July 2017 - present
The University of Western Ontario
Position
  • Professor (Associate)
September 2010 - April 2015
The University of Western Ontario
Position
  • Research Assistant
September 2010 - present
London Health Sciences Centre
Position
  • Consultant Psychiatrist

Publications

Publications (92)
Article
Full-text available
The pharmacological treatment of depression consists of stages of trial and error, with less than 40% of patients achieving remission during first medication trial. However, in a large, randomized-controlled trial (RCT) in the U.S. (“GUIDED”), significant improvements in response and remission rates were observed in patients who received treatment...
Article
The primary objective was to determine whether depression and anxiety influence the outcome of random microevents in a nonrandom manner in the absence of any physical intervention by using a random event generator (REG). The secondary objective was to correlate other dimensions of consciousness with the REG's output. The experimental group (n = 30)...
Article
Full-text available
Background: Between 20-50% of patients undergoing maintenance dialysis for end-stage kidney disease experience symptoms of depression and/or anxiety, associated with increased mortality, greater health care utilization, and decreased quality of life. It is unknown whether mindfulness-based interventions can improve depression and anxiety symptoms...
Article
Full-text available
Objectives Objective 1: To determine if it is feasible to conduct an RCT of online Sudarshan Kriya Yoga (SKY) for frontline hospital and long-term care home staff under the constraints imposed by the COVID-19 pandemic and need for remote trial monitoring. Objective 2: To assess whether online versions of SKY and/or Health Enhancement Program (HEP)...
Article
Full-text available
Parents of children with inborn errors of metabolism (IEM) face numerous psychosocial challenges. An increased understanding and awareness of these stressors can ensure better overall outcomes for the entire family. We conducted semi-structured, in-person interviews with ten parents to identify psychosocial stressors, strategies, and supports they...
Chapter
Manic syndromes in the elderly are different from those seen in the younger bipolar population. They are a heterogeneous group but can probably be divided into two main groups based on age of onset of the illness: late-onset bipolar disorder (LOB) and early-onset bipolar disorder (EOB). This chapter elaborates on differences in these two groups bas...
Article
Background: Sudarshan Kriya Yoga (SKY), a breath-based yoga intervention, has demonstrated safety and efficacy in posttraumatic stress disorder (PTSD) patients subsequent to natural disaster or war, but has not been explored in civilians with PTSD from a wider range of trauma. We hypothesized that it would be feasible to conduct a clinical trial o...
Article
Full-text available
Background Despite the high prevalence of comorbid chronic pain and depression, this comorbidity remains understudied. Meditation has demonstrated efficacy for both chronic pain and depression independently, yet there have been few studies examining its effectiveness when both conditions are present concurrently. Furthermore, while meditation is ge...
Article
Mindfulness, Mindfulness Based Cognitive Therapy MBCT and based Problem-solving therapy (PST) techniques have emerging research supporting them as positive additions to treatment as usual/standard care for mood, anxiety and/or cognitive disorders among older adults. This session will highlight this recent research and evidence of the benefits of th...
Article
Introduction Prior literature has proposed that the co-existence of late-life depression, executive dysfunction and impaired gait speed may constitute a specific phenotype in older adults with a possible shared brain mechanism. All three conditions are independently associated with negative health outcomes including impaired function, risk of falli...
Preprint
Full-text available
Background: Despite the high prevalence of comorbid chronic pain and depression, this comorbidity remains understudied. Meditation has demonstrated efficacy for both chronic pain and depression independently, yet there have been few studies examining its effectiveness when both conditions are present concurrently. Furthermore, while meditation is g...
Preprint
Full-text available
Background: Despite the high prevalence of comorbid chronic pain and depression, this comorbidity remains understudied. Meditation has demonstrated efficacy for both chronic pain and depression independently, yet there have been few studies examining its effectiveness when both conditions are present concurrently. Furthermore, while meditation is g...
Preprint
Full-text available
Background: Despite the high prevalence of comorbid chronic pain and depression, this comorbidity remains understudied. Meditation has demonstrated efficacy for both chronic pain and depression independently, yet there have been few studies examining its effectiveness when both conditions are present concurrently. Furthermore, while meditation is g...
Article
Full-text available
Background: Recent estimates suggest an 11% prevalence of current late-life depression (LLD) and a lifetime prevalence of 16-20%. LLD leads to cognitive disturbance as well as a nearly two to three times increased risk of dementia. We conducted a recent randomized controlled trial (RCT) which demonstrated that Sahaj Samadhi meditation (SSM), an ea...
Article
Prior literature has proposed that the coexistence of late-life depression, executive dysfunction and impaired gait speed may constitute a specific phenotype in older adults with a possible shared brain mechanism. All three conditions are independently associated with negative health outcomes including impaired function, risk of falling, and reduce...
Article
Mindfulness and transcendental meditation techniques have emerging research supporting them as positive additions to treatment as usual/standard care for mood and/or cognitive disorders among older adults. This session will highlight this recent research and evidence of the benefits of these interventions in the context of late-life depression (LLD...
Article
Background Late-life depression (LLD) is a disabling disorder and antidepressants are ineffective in as many as 60% of cases. Converging evidence shows a strong correlation between LLD and subsequent risk of cardiovascular disease. There is a need for new, well-tolerated, non-pharmacological augmentation interventions that can treat depressive symp...
Article
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: 1. To determine the efficacy of any pharmacotherapeutic intervention compared to placebo or an alternative drug: 1.1 in alleviating acute manic episodes of bipolar disorder in the older person;1.2 in alleviating depressive symptoms in acute episodes of bipolar d...
Article
Background: Current pharmacological treatments and psychotherapeutic approaches often have adverse effects or are ineffective in late-life cognitive and mental illnesses. Mind-body interventions offer a holistic approach and are of interest because of potential patient acceptability and scalability. Objective: To synthesize current evidence on m...
Article
Full-text available
Objectives: To compare the dual-task gait performance of older adults with Late-Life Depression (LLD) versus Mild Cognitive Impairment (MCI). Design: Cross-sectional study with three matched groups: LLD, MCI and non-depressed and cognitively intact (NDCI). Setting: LLD group participants were recruited from geriatric psychiatry clinics in Lond...
Article
Bipolar disorder prevalence rates vary in the older adult population (defined as age ≥ 65 years), ranging from 1% in community dwellers to as high as 8–10% in hospital inpatients. Although older agents, including lithium and valproic acid, offer significant antimanic efficacy, as supported by a recent randomized controlled trial (RCT), there is gro...
Article
Objectives The objective of this study was to assess the prevalence of orthostatic hypotension (OH) in a sample of late life depression (LLD) patients and to determine the validity of a standardized questionnaire, the Orthostatic Hypotension Questionnaire (OHQ). Secondarily, we wished to assess variables associated with OH. Methods We conducted a...
Article
Full-text available
Background A new paradigm is emerging in which mobility and cognitive impairments, previously studied, diagnosed, and managed separately in older adults, are in fact regulated by shared brain resources. Deterioration in these shared brain mechanisms by normal aging and neurodegeneration increases the risk of developing dementia, falls, and fracture...
Article
Full-text available
Background: Physical exercise, cognitive training, and vitamin D are low cost interventions that have the potential to enhance cognitive function and mobility in older adults, especially in pre-dementia states such as Mild Cognitive Impairment (MCI). Aerobic and progressive resistance exercises have benefits to cognitive performance, though eviden...
Article
Full-text available
Background Canada, a temperate country with four defined seasons incurs an annual productivity loss of over $30 billion on major depressive disorder (MDD); however it remains unknown whether inpatient hospitalization for MDD exhibits seasonal variations. Objective Our study objective was to determine if there are seasonal variations in hospitaliza...
Article
Objectives: Antidepressants are associated with an increased risk of falls although little is known of the comparative risks of different types of antidepressants or individuals who are at greatest risk for falls. We examined the association between new use of antidepressants and fall-related injuries among older adults in long-term care (LTC). D...
Article
Full-text available
The ventromedial prefrontal cortex's (vMPFC) role in regulating emotions in late life depression (LLD) remains unclarified. We assessed vMPFC activation in an emotional valence blood oxygenation level-dependent (BOLD) functional magnetic neuroimaging (fMRI) task and related the findings to extent of white matter hyperintensities (WMH). Sixteen part...
Conference Paper
Depression in older adults is a pervasive and complex issue associated with poor health outcomes (Carter, Rodda & Walker, 2011). TELEPROM-G is a mobile-based TELEmedicine and Patient-Reported Outcome Measurement (PROM) platform designed to enhance delivery of health services among community-based older adults. This one-year pilot study will develop...
Article
Full-text available
Background: The risk of ventricular arrhythmia with citalopram and escitalopram is controversial. In this study we investigated the association between these two drugs and the risk of ventricular arrhythmia. Methods: We conducted a population-based retrospective cohort study of older adults (mean age 76 years) from 2002 to 2012 in Ontario, Canad...
Data
ICD 10 Codes for the Study Outcomes. a Only ICD 10 Codes were used to identify outcomes due to the timing of our study. These codes had to be associated with a hospital presentation in any position (e.g. most responsible diagnosis, or secondary diagnosis). b Data obtained from the Ontario Registered Persons Database and the Ontario Registrar Genera...
Data
Percentage of high dose citalopram (>20mg/day) or escitalopram (>10mg/day) prescriptions for each year prior to weighting. (DOCX)
Data
Checklist of Recommendations for Reporting of Observational Studies Using the STROBE Guidelines. (DOCX)
Data
Variables included in the Propensity Score. Abbreviations: Selective serotonin re-uptake inhibitor (SSRI), Local Health Integration Network (LHIN). aLHIN—Local Health Integration Network, health authorities responsible for regional administration of public healthcare services in Ontario; b computed tomography of a body area other than the head; c R...
Data
High vs Low doses of Selective Serotonin Re-uptake Inhibitors. ** These doses are considered to be equivalent amongst the different types of selective serotonin re-uptake inhibitors. (DOCX)
Data
Summary of published studies describing ventricular arrhythmia/ QT prolongation/ Cardiac events/ mortality associated with citalopram or escitalopram use. Abbreviations: CI = confidence interval. aWe evaluated the quality of individual studies using the Downs and Black quality assessment method, which is a list of 27 criteria to evaluate both rando...
Data
Modified Downs and Black checklist for the assessment of the methodological quality of both randomized and non-randomized studies. aItem has been modified; specifically, the scoring for this question was simplified to a choice of awarding either 1 or 0 points depending on whether there was sufficient power to detect a clinically important effect. (...
Data
Database Codes for Baseline Characteristics. Abbreviations: CCI—Canadian Classification of Health Interventions (available after 2002), CCP—Canadian Classification of Diagnostic, Therapeutic and Surgical Procedures (before 2002), DSM—IV—Diagnostic and Statistical Manual of Mental Disorders IV coding, ICD 9 —International Classification of Diseases,...
Article
Full-text available
Late-life depression affects 2–6% of seniors aged 60 years and above. Patients are increasingly embracing non-pharmacological therapies, many of which have not been scientifically evaluated. This study aimed to evaluate a category of meditation, automatic self-transcending meditation (ASTM), in alleviating symptoms of depression when augmenting tre...
Article
Full-text available
The prevalence of dementia continues to grow worldwide due to an aging population and is projected to affect 65.7 million people by 2030 (World Health Organization, 2012). Behavioral and psychological symptoms of dementia (BPSD), including agitation, anxiety, aggression, depression, and psychosis, can occur in as much as 80% of the affected populat...
Article
Objective: Guidelines worldwide have cautioned against the use of antipsychotics as first-line agents to treat neuropsychiatric symptoms of dementia. We aimed to investigate the changes over time in the dispensing of antipsychotics and other psychotropics among older adults with dementia living in long-term care facilities. Methods: We used drug...
Article
Objective: To perform an exploratory review of the association between autonomic function and depressive symptoms/major depressive disorder (MDD) with a particular emphasis on their combined impact on cardiovascular health across the lifespan. Method: A review of computerized databases was performed using PubMed, Medline, PsycINFO, Scopus, Google S...
Article
Full-text available
Background The prevalence and socioeconomic cost of late life depression (LLD) is on the rise, while the response rate to antidepressant trials remains poor. Various mind-body therapies are being embraced by patients as they are considered safe and potentially effective, yet little is known regarding the effectiveness of such therapies to improve L...
Article
Purpose – The 2006 Post Graduate Medical Education Trust Board (PMETB) trainees' survey indicated inadequacies in handover procedures amongst medical and psychiatry trainees nationwide; and in 2007 a local psychiatry trainees' survey found inadequate handover procedures. The purpose of this paper is to show how to improve handover practice through...
Chapter
This is the protocol for a review and there is no abstract. The objectives are as follows: 1. To determine the efficacy of any pharmacotherapeutic intervention compared to placebo or an alternative drug: 1.1 in alleviating acute manic episodes of bipolar disorder in the older person; 1.2 in alleviating depressive symptoms in acute episodes of bipol...
Article
Full-text available
Delirious mania has been well recognized in the published literature and in the clinic. Over the years there has been refinement of understanding of its clinical features, course, and treatment. The literature suggests that delirious mania should be considered in individuals who present with a constellation of sudden onset delirium, mania, and psyc...
Article
Full-text available
Bipolar disorder is a common recurrent illness with high levels of chronicity. Treatment resistance persists despite the use of established medications, such as lithium and valproate. New medications are required for the treatment of refractory cases. Some open-label reports have suggested that the anticonvulsant tiagabine may be efficacious in bip...
Article
Full-text available
La oxcarbazepina, un cetoderivado del “estabilizador del estado de ánimo” carbamazepina, puede ser efectiva en el tratamiento de los episodios agudos del trastorno bipolar. Potencialmente, puede ofrecer ventajas farmacocinéticas sobre la carbamazepina. Objetivos: Revisar la eficacia y la aceptabilidad de la oxcarbazepina en comparación con el place...
Article
To explore the relationship between specific aspects of cognition, white matter hyperintensities (WMHs), and cardiovascular autonomic parameters in late-life depression (LLD). Cross-sectional analysis. Secondary care psychiatry. Forty-one individuals older than 60 years, with current or previous history of major depression, and 32 age-matched compa...
Article
A limited number of studies have demonstrated changes in cerebral blood flow (CBF) in older individuals with depression, but there are considerable inconsistencies between studies. To investigate changes in CBF using arterial spin labelling (ASL) magnetic resonance imaging (MRI) in people with late-life depression and in a similarly aged healthy co...
Article
Oxcarbazepine, a keto derivative of the 'mood stabiliser' carbamazepine, may have efficacy in the treatment of acute episodes of bipolar disorder. Potentially, it may offer pharmacokinetic advantages over carbamazepine. To review the efficacy and acceptability of oxcarbazepine compared to placebo and other agents in the treatment of acute bipolar e...
Article
Tiagabine, an anticonvulsant, has been reported to have efficacy in prophylactic treatment of bipolar disorder in case reports and in case series. To assess the efficacy and acceptability of tiagabine, relative to placebo, and other agents in the prevention or attenuation, or both, of episodes of bipolar disorder in adults. The efficacy and accepta...
Chapter
Another chronic illness frequently seen in the older population is depression. The estimates of the prevalence of this condition vary from 1% to 20% [1, 2], rates being much higher for those who are in hospital, those who need home help care and those in long term care. Depression, though, remains poorly diagnosed and subsequently treated and as a...
Article
Full-text available
Structural brain abnormalities are associated with late-life major depression, with numerous studies reporting increased white matter hyperintensities (WMH) and reduced cortical/subcortical grey matter volumes. There is strong evidence linking vascular disease to WMH, but limited evidence on its association with subcortical volumes. To investigate...
Article
Numerous studies have revealed white matter abnormalities in late-life depression (LLD). The objective was to investigate the integrity of white matter tracts in subjects with LLD compared to similar aged healthy individuals using diffusion tensor imaging (DTI). Sixty eight subjects (30 healthy individuals, 38 depressed) underwent DTI on a 3T scann...
Article
Numerous studies have revealed structural brain changes in late life depression, mainly in white matter or whole lobes with few focussing just on grey matter (GM). The objective was to investigate GM changes in older depressed and similar aged healthy subjects using two different methods, cortical thickness in frontal lobe structures and voxel-base...
Article
Full-text available
A case of a 79-year-old woman, who was admitted to a hospital subsequent to a mechanical fall and ophthalmic herpes zoster infection, is presented. She also presented with features of giving approximate answers, fluctuating consciousness, somatic conversion symptoms and probable hallucinations. A presumptive diagnosis of Ganser's syndrome was made....
Article
To determine if subjects with late-life depression have significant cardiovascular autonomic abnormalities (orthostatic blood pressure drop, heart rate variability and baroreflex sensitivity). A case-control study, in secondary care facilities, of forty two older (> 60 years) individuals with lifetime history of major depression and 31 age and sex...
Article
Full-text available
Aims and method The Annual Review of Competence Progression (ARCP) is a process of checking and evaluating evidence of competency attainment collected by a trainee over the preceding year. There has been no study evaluating trainees' perception of this new process. Two cross-sectional electronic surveys were conducted a year apart in the north of E...
Article
We explored phenotypic parameters of people with Huntington's disease who had been admitted to a psychiatric unit and then discharged, with a view to determining prognostic factors for discharge to higher levels of care. A cross-sectional study was carried out on 19 patients admitted to a psychiatric unit with Huntington's disease. Data on the Unif...
Article
Bipolar disorder is a chronic disorder of mood which leads to episodes of either elevated mood or depression in a sizable number of adults in the community (1%). Though the prevalence rates in the elderly are lower in the community (up to 0.1%), there is significantly higher morbidity in protected environments like care homes and hospital settings...