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Kar, Nilamadhab

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Prof Nilamadhab Kar is actively involved in mental health research along with clinical work. His research interests include stress-related mental disorders specifically posttraumatic stress disorder, suicide prevention, and clinical psychopharmacology. He has also conducted epidemiological work on mental health consequences following disasters. He is engaged in public education programmes in mental health. He has more than 300 scientific publications including articles, book chapters, and medical textbooks. His recent research highlights include unmet mental health needs of the survivors of disasters, validation of the quality of life scales in different languages to be used in psychiatric settings, the influence of lifestyle on metabolic syndrome in psychiatric patients, and mental health concerns of hyperthyroidism. Besides scientific articles, he also writes newspaper columns on mental health for public education. He is the editor of the Journal of Geriatric Care and Research and is on the editorial board of a few medical and literary journals. He is engaged in various charitable works through the Geriatric Care and Research Organisation (GeriCaRe), which has received a national award from the Government of India. He is associated with the Quality of Life Research and Development Foundation and the Institute of Insight supporting health research and public education.

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Now showing 1 - 10 of 71
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    Worry and media use behavior during COVID-19 pandemic
    (Horizon Journals, 2022) Kar, Brajaballav; Kar, Shreyan; Kar, Nilamadhab
    Background: Information seeking occurs to reinforce existing information, to solve problems, construct meaning, and as a response to alienation. The continual information uncertainty related to COVID-19 pandemic impacted life, livelihood and triggered worry. Information seeking from multiple sources became necessary to allay anxiety and verify authenticity. This research investigated the various sources of information, and its influence on their level of worry.Methods: An online survey required respondents to indicate their sociodemographic details, different information sources used, awareness of rumors, the ability to check the authenticity of the information, sources, and COVID-19 related experiences. The lowest and highest for worry scale was 1—10. Results: The median worry during the period was seven, and the number of media accessed was five. Overall worry correlated significantly with other worries (personal and family health, income, job, and lack of growth). Worry differed significantly among age groups, education, occupation, and marital status but not across gender and economic status. Individuals, who self-isolated, experienced issues with rumors, feared infection and death reported significantly more worry. Awareness, fear of infection, and rumors influenced significantly more number of media use.Conclusions: The extent of worry and the number of information sources showed complex and non-linear ‘U’ shaped relationship with the lowest at six sources. The article extends the information-seeking behavior literature by indicating that the use of a higher number of media sources is counterproductive. Understanding information exchange and information sources can help address public worry
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    Health concerns in elderly: a survey and public education in Bhubaneswar, India
    (I-Scholar, 2019-12-01) Kar, Shreyan; Das, Tushar K.; Mohapatra, Prasanta K.; Kar, Brajaballav; Senapati, Anupama; Kar, Nilamadhab
    Background: While it is apparent that old age is associated with multiple health concerns the extent of its multiplicity suggestive of the burden is often not clear. It was intended to find out self-reported health concerns for the duration of one month and cardiovascular risk factors in older adults. Method: In a cross-sectional survey attendees of a Healthy Ageing Conference were approached with a semi-structured questionnaire about their health concerns and cardiovascular risks. Risk of cardiovascular event in 10 years based on QRISK3 was calculated. Results: A considerable proportion of elderly had range of physical symptoms, depressive mood state and memory problems. Mean number of health problems reported were 4.8±3.3 (male 4.4±3.1 and female 5.0±4.3). Cardiovascular risk was high, mean QRISK3 score for males were 22.2% (±14.4) and for females 10.3% (±6.6) (p<0.05). On an average the heart age was increased by 7.9±6.2 years (8.6±6.6 years for males and 5.0±3.3 for females). The relative risk was 2.1 for males and 1.5 for females. The symptoms and risk factors were elicited easily and the process probably facilitated improving the awareness about the health concerns holistically. Conclusions: The results suggested the extent of health concerns in general and cardiovascular risks in particular and may help to reflect about required range of appropriate public health awareness and intervention programmes in the community.
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    Mental health in the university campus: emphasizing the need for preventive health actions
    (MedKnow, 2021-06) Rath, Namita; Kar, Shreyan; Kar, Nilamadhab
    Background: Life in college and university can be stressful. It was intended to evaluate mental health, specifically depression, anxiety, substance use, and stress among management students to explore the need for support in a campus. Methods: It was a cross-sectional study in the setting of a university campus. Using a questionnaire method, students of the Master of Business Administration course were evaluated for stress, depression, anxiety, and substance use. Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 were used for assessing anxiety and depression. Stress explored through open-ended questions was later categorized. Results: Majority of students (60.7%) reported stress which was broadly course-related and personal issues. Stress was significantly associated with anxiety and depression. Around 36.1% of students had anxiety and 44.2% had depression at a clinically relevant level. The proportion of students reporting wish to die or self-harm ideas nearly every day was 11.5%. Substance use was reported by 18.3%. In contrast to these proportions, only 10% of students acknowledged having mental health problems. Conclusion: Considerable mental health concerns exist in students. The results highlight the need for specific mental health promotion and preventive health actions in a university campus.
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    Risk of personality disorder in students of business administration
    (Elsevier, 2013-09-20) Kar, Nilamadhab; Rath, Namita; Black Country Partnership NHS Foundation Trust, Wolverhampton, United Kingdom; Faculty in Management Studies, Academy of Management Studies, Bhubaneswar, India.
    Sir, Relevance of understanding personality profile of administrators is immense. Assessment of attitude and personality factors in the prospective employees especially those with management role are not new; however, there is hardly any information on the prevalence of dysfunctional personality traits or risk of personality disorder (PD) in students pursuing courses for business administration in the Academy of Management Studies, Bhubaneswar, 111 India...
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    War and older adults: consequences and challenges
    (GeriCaRe, 2022-05) Kar, Nilamadhab
    The catastrophic nature of war has deleterious impact on almost all individuals of the affected populations; amongst them older adults are known to be one of the most vulnerable groups. Along with the life changing economic and social adversities, the physical and mental health of the older adults are seriously impaired secondary to war. The consequences are immediate; but most continue long-term; in fact, experiences of the war have lifelong impact. In addition, people who are exposed to war in younger age continue to have health related morbidities in the old age. There are enormous needs for protection, support and care of older adults during and in post-war situations. While efforts should be taken to mitigate the devastating effect of the war on all, including the elderly people; it is important to prevent war at all costs
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    What can we learn from the COVID pandemic about care of older adults?
    (GeriCare, 2021-07) Kar, Nilamadhab
    The elderly population has been worst hit during the COVID pandemic. Society should take this challenge to learn from the experience to improve the support services for the elderly and preparedness for pandemic. Proper planning and strategies in health, social care, and public services are required
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    Prescribing of psychiatric drugs in pregnancy: a review of current practice in a community mental healthcare setting
    (Cambridge, 2022-06-20) Kar, Nilamadhab; Hickling, Lucy
    Aims: Prescribing of psychotropic medications in pregnancy is still considered a ‘grey area’ in clinical practice. National Institute for Health and Care Excellence (NICE) in the UK suggests that the decisions should be person-specific, considering the risks to both the mother and unborn child, and the patient is supported to make an informed decision. It is important to explore the use of psychotropic medications during pregnancy, or lack of it, and its subsequent impact on maternal mental health. It was intended to review the decisions expectant mothers are making regarding taking psychiatric medications during pregnancy, and the associated clinical outcomes. Their mental capacity for taking decisions was also checked. Methods: A retrospective audit of case notes of patients (n = 16) known to community psychiatric team (CMHT) and specialist perinatal mental health (PNS) services in Wolverhampton, who notified their pregnancy between December 2020 and December 2021. Demographic and clinical data were collected from the electronic records. Results: The sample had a mean age of 28.8 ± 6.3 years (range: 19 to 39 years), and 68.8% of them were Caucasian. A wide range of psychiatric diagnoses were present, most (62.5%) had comorbid diagnoses; and 25% had substance use, most commonly cannabis. Mean duration of gestation at the review following notification of pregnancy was 14.5 ± 7.7 (range: 6 to 29) weeks. It was observed that 25% were not taking psychiatric medications prior to pregnancy, 43.8% stopped taking their medication prior to the psychiatric review, most stopping abruptly, and 31.2% had continued their medication. The medications included aripiprazole, olanzapine, quetiapine, venlafaxine, sertraline and promethazine. Following the review, only 18.8% continued their medications. Of the 13 (81.3%) patients who were not taking medications, 9 (69.2%) had adverse mental health outcomes, with 2 (15.4%) patients requiring inpatient care. However, later 8 (61.5%) started taking medications whilst under the care of PNS. All of them had mental capacity to decide regarding their psychiatric treatment at the review. Conclusion: Most psychiatric patients avoided taking psychotropic medications initially during pregnancy, however, a considerable proportion restarted their medications following review with the perinatal psychiatry team. The majority of patients who did not take medications had negative mental health consequences. It is important to develop an evidence base about the use of psychiatric medications in pregnancy and the associated short and long-term outcomes that may help the quality of information shared with patients.
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    Suicide by psychiatric patients: nature of risk, risk categorisation and preventability
    (SAGE Publications, 2019-08-03) Kar, Nilamadhab; Prasad, Tulika; Department of Psychiatry, Black Country Partnership NHS Foundation Trust, Steps to Health, UK; Department of Psychiatry, Black Country Partnership NHS Foundation Trust, Penn Hospital, UK.
    This study considers risk factors associated with suicide by psychiatric patients, the perceived risk at last contact and risk categorisation and reflects upon the potential for prevention. Information regarding 63 consecutive suicides known to mental health services in Wolverhampton, UK, over a 15-year period was collected as part of an audit using a semi-structured questionnaire covering sociodemographic and clinical risk factors, along with information about preventability. A complex mixture of historical, enduring and current risk factors was observed. In addition to common risk factors, a considerable proportion had histories of multiple co-morbid psychiatric (52.5%) and physical diagnoses (27.6%) and psychiatric admission (70.5%). Common suicide methods included hanging (36.5%) and poisoning (36.5%). Most suicides occurred in the post-discharge months up to around two years (75.8%). Although a range of psychopathologies and suicidal cognitions were observed at the last clinical contact, the immediate suicide risk was considered low (46.2%) or not present (38.5%) in the majority of cases. Clinicians suggested various factors that could have made suicides less likely. Clinical assessment can identify risk factors, but categorisation may not be indicative of the outcome. A focus on modifiable factors, with support for psychosocial and clinical issues, may assist with prevention.
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    Social trust and COVID-appropriate behavior: learning from the pandemic
    (Wolters Kluwer, 2023) Kar, Brajaballav; Kar, Nilamadhab; Madhu, Panda
    Introduction: General trust and trust in various social institutions/agents are argued to positively influence the outcome, more so, in a crisis. Mitigating a crisis requires actions from individuals, family, friends, co-workers, various policymaking, and implementing agencies, media, and other agencies with whom people interact. In the COVID-19 situation, people individuals did not have a choice but to access essential services even with the risk of infection. Personal experiences also guide individuals' trust in various social groups and are responsible for taking individual action of protecting themselves in the pandemic. To what extent people trusted various social groups and observed appropriate behavior is investigated in this research. Methods: Responses were collected through a structured, web-based questionnaire where respondents self-reported their trust in various social agents and the extent to which they observed COVID-appropriate behavior. Respondents primarily belonged to the eastern part of India. Results: This study finds significant demographic differences in observing appropriate behavior leading to an identification of a vulnerable group. Second, trust in the inner group (family, friends, neighbors, and co-workers among others) is least important whereas trust in professionals and administrative institutions is the most important. Trust in the central government, media, and politicians among others is counterproductive to observing the appropriate behavior. Conclusion: People repose higher trust in professionals and administrative institutions in a crisis situation. Professional and administrative leadership helps in more effective crisis management leading to better behavioral compliance of the public. Any other leadership may be ineffective or counter-productive.
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    Exploring the complex relationship between obesity and mental health: a narrative review
    (Wolters Kluwer, 2023-07) Kar, Nilamadhab; Kar, Sneha
    Obesity is a major public health problem worldwide. Its association with multiple physical morbidities is well known. Although there is a massive impact of obesity on mental health, these areas are not adequately highlighted. Following a comprehensive literature search, this narrative review describes the complex relationship of obesity and mental health, reflecting on its clinical relevance. Obesity is a psychologically stressful factor in itself; it is also associated with stigma, discrimination, abuse, social ridicule, isolation, and various other challenges. Obesity affects body image perception, self‑esteem, and mood, along with social and occupational activities. Obesity is associated with many psychiatric illnesses, e.g., depression, anxiety, stress‑related disorders, psychoses, bulimia nervosa, binge eating, cognitive impairment, and dementia, in various ways, as a risk factor or clinical feature. Weight gain and obesity are also common side effects of different psychiatric drugs. Along with its impact on mental health, obesity impairs quality of life. It is essential to improve awareness about the relationship of obesity and mental health, and to take necessary steps to prevent, manage, and reduce the impact of obesity.