Vasudeo Paralikar

• MD (Psy), PhD
• Principal Investigator at KEM Hospital Research Centre

Introduction Stigma contributes to a significant part of the burden of schizophrenia (SCZ), therefore reducing false positives from the diagnosis would be liberating for the individuals with SCZ and desirable for the clinicians. The stigmatization associated with schizophrenia advocates the need for high-precision diagnosis. In this study, we prese...

A Cultural Formulation Interview (CFI) field trial in India, widely reported racist violence in the United States, and casteist and religious communal conflicts in India highlighted inattention to structural issues affecting mental health problems in the Outline for Cultural Formulation (OCF) and the CFI in the Diagnostic and Statistical Manual of...

The need for molecular biomarkers for schizophrenia has been well recognized. Recently, peripheral blood gene expression profiling and machine learning (ML) tools have become popular for biomarker discovery. The stigmatization associated with schizophrenia advocates the need for diagnostic models with higher precision. In this study, we propose a s...

Schizophrenia is a disorder that is characterized by delusions, hallucinations, disorganized speech or behavior, and socio-occupational impairment. The duration of observation and variability in symptoms can make the accurate diagnosis difficult. Identification of biomarkers for schizophrenia (SCZ) can help in early diagnosis, ascertaining the diag...

To the Editor In a Viewpoint, Dr Guinart et al¹ highlighted the need for fuller consideration of transcultural psychiatry to better explain cultural variation in clinical trials of psychotropic medicines. As the article suggested, such research is bedeviled by questions of interrater reliability, variations in the expression of stigmatizing emotion...

Background: India's Mental Healthcare Act, 2017 (MHCA) greatly restricts the use of electroconvulsive therapy (ECT) in minors and bans unmodified ECT. Indian psychiatrists have raised concerns that these measures may deprive certain patients of life-saving treatment. This study describes the perspectives of Indian psychiatrists on how ECT is dealt...

Purpose – India’s Mental Healthcare Act 2017 provides a right to mental healthcare, revises admission and review procedures, effectively decriminalises suicide and has strong non-discrimination measures, among other provisions. The purpose of this paper is to examine Indian mental health professionals’ views of these changes as they relate to stigm...

The DSM-IV Outline for Cultural Formulation (OCF) was a framework for assessment based on principles of cultural psychiatry. The Cultural Formulation Interview (CFI) for DSM-5 provided a tool enabling wider use of cultural formulation in clinical cultural assessment. Validation to justify the inclusion of the CFI in DSM-5 involved quantitative anal...

Background: The Cultural Formulation Interview (CFI) in DSM-5 focuses on the cultural identity (CI) and illness explanatory models of individual patients. In India, clinicians frequently see patients with their family. A family version of the CFI is needed, especially in such family-centric societies like India. Purpose: Plan development and testin...

Background: Expression of cultural identity (CI) reflects personal and family values, which may have positive and/or negative associations. In clinical field trials of the Cultural Formulation Interview for DSM-5 (CFI) in Pune, respondents’ difficulty understanding, and clinicians’ difficulty assessing CI indicated need for improved assessment. Pur...

Background: There is a need for clinical tools to identify cultural issues in diagnostic assessment. Aims: To assess the feasibility, acceptability and clinical utility of the DSM-5 Cultural Formulation Interview (CFI) in routine clinical practice. Method: Mixed-methods evaluation of field trial data from six countries. The CFI was administere...

Focus of prevention and treatment for Child Sexual Abuse (CSA) has been victims and caregivers. Treating potential and actual sex offenders as means of primary prevention appears to be the need to deal with this public health problem. We cannot implement trends in other cultures in Indian contexts. Taboo regarding sexuality and medico-legal conflic...

Objective This study’s objective is to analyze training methods clinicians reported as most and least helpful during the DSM-5 Cultural Formulation Interview field trial, reasons why, and associations between demographic characteristics and method preferences. Method The authors used mixed methods to analyze interviews from 75 clinicians in five co...

Despite the important roles families play in the lives of many individuals with mental illness across cultures, there is a dearth of data worldwide on how family members perceive the process of cultural assessment as well as to how to best include them. This study addresses this gap in our knowledge through analysis of data collected across six cou...

Development of the cultural formulation interview (CFI) in DSM-5 required validation for cross-cultural and global use. To assess the overall value (OV) of CFI in the domains of feasibility, acceptability, and utility from the vantage points of clinician-interviewers, patients and accompanying relatives. We conducted cross-sectional semi-structured...

Depression, though generally episodic, results in lasting disability, distress, and burden. Rising prevalence of depression and suicide in the context of epidemiological transition demands more attention to social dimensions like gender related stresses, dysfunction, and their role in outcome of depression. Cross-sectional and follow-up assessment...

Disorders emphasizing symptoms of fatigue and/or weakness, collectively termed Neurasthenia Spectrum Disorders (NSDs), typically emphasize a biological basis in the West and social origins in East Asia. In India, explanatory concepts are diverse. To clarify, 352 outpatients in Psychiatry, Medicine, Dermatology, and Ayurved clinics of an urban hospi...

In their comparative epidemiological study of chronic fatigue syndrome in Brazil and London, Cho et al [1][1] conclude that cultural differences affect only the recognition, rather than occurrence, of this condition. Although a reasonable interpretation of the epidemiological data, without

Disorders of unexplained fatigue are researched globally and debated prominently concerning their biomedical and psychiatric comorbidity. Such studies are needed in India. To identify biomedical markers and psychiatric morbidity of disorders of severe unexplained fatigue or weakness with disability, designated neurasthenia spectrum disorders (NSDs)...

Disorders of fatigue are important in clinical practice but inadequately studied in developing countries. Questions about their consistency and variation across cultures also require attention. The standard professional diagnostic formulations of these disorders, namely, chronic fatigue syndrome and neurasthenia, are not used widely in India, perha...

Clinically significant fatigue or weakness is a common but understudied clinical problem in India. The applicability and relevance of Western clinical criteria in this setting are not studied. Alternative criteria sets used in different clinical contexts suggest a range of conditions constituting neurasthenia spectrum disorders (NSDs). We therefore...

We assessed the extent of anxiety/depression/distress using Hospital Anxiety and Depression Scale (HADS) among a cross-section of HIV test-seekers at a Voluntary Counseling and Testing (VCT) facility in Pune, India. HADS has 14 items for uniscale with 7 items each for anxiety and depression rated on a four-point Likert scale. Between September 2002...

1. It has been proposed that an increase in the concentration of the neuromodulator phenylethylamine at the post-synaptic dopamine receptor may be involved in the etiology of schizophrenia. If this increase is the case, a reduction in the CSF and/or serum concentrations of phenylacetic acid, its major metabolite, might be anticipated. 2. The author...