Brief culturally adapted CBT for psychosis (CaCBTp): A randomized controlled trial from a low income country

Naeem, Farooq; Saeed, Sofiya; Irfan, Muhammad; Kiran, Tayyeba; Mehmood, Nasir; Gul, Mirrat; Munshi, Tariq; Ahmad, Sohail; Kazmi, Ajmal; Husain, Nusrat; Farooq, Saeed; Ayub, Mahmood; Kingdon, David

doi:10.1016/j.schres.2015.02.015

Cited by 79 publications

(83 citation statements)

References 29 publications

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“…We propose a dual strategy of developing both a smaller group of master trainers/supervisors (e.g., exercise physiologists and physiotherapists) and researchers and a larger group of practitioners (e.g., nurses) trained in the basics of cognitive behavioral physical activity strategies. This method has been successfully employed for cognitive behavioral therapy in trials in LMICs [59, 60]. A stepped-care approach, where patients start with self-management, may be a feasible strategy in LMIC settings.…”

Section: Discussionmentioning

confidence: 99%

Chronic physical conditions, multimorbidity and physical activity across 46 low- and middle-income countries

Vancampfort

Koyanagi

Ward

et al. 2017

Int J Behav Nutr Phys Act

141

123

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BackgroundThere are no nationally representative population-based studies investigating the relationship between physical activity, chronic conditions and multimorbidity (i.e., two or more chronic conditions) in low- and middle-income countries (LMICs), and studies on a multi-national level are lacking. This is an important research gap, given the rapid increase in the prevalence of chronic diseases associated with lifestyle changes in these countries. This cross-sectional study aimed to assess the association between chronic conditions, multimorbidity and low physical activity (PA) among community-dwelling adults in 46 LMICs, and explore the mediators of these relationships.MethodsWorld Health Survey data included 228,024 adults aged ≥18 years from 46 LMICs. PA was assessed by the International Physical Activity Questionnaire (IPAQ). Nine chronic physical conditions (chronic back pain, angina, arthritis, asthma, diabetes, hearing problems, tuberculosis, visual impairment and edentulism) were assessed. Multivariable logistic regression and mediation analyses were used to assess the association between chronic conditions or multimorbidity and low PA.ResultsOverall, in the multivariable analysis, arthritis (OR = 1.12), asthma (1.19), diabetes (OR = 1.33), edentulism (OR = 1.46), hearing problems (OR = 1.90), tuberculosis (OR = 1.24), visual impairment (OR = 2.29), multimorbidity (OR = 1.31; 95% CI = 1.21–1.42) were significantly associated with low PA. More significant associations were observed in individuals aged ≥50 years. In older adults, depression mediated between 5.1% (visual impairment) to 23.5% (angina) of the association between a chronic condition and low PA. Mobility difficulties explained more than 25% of the association for seven of the eight chronic conditions. Pain was a strong mediator for angina (65.9%) and arthritis (64.9%), while sleep problems mediated up to 43.7% (angina) of the association.ConclusionsIn LMICs, those with chronic conditions and multimorbidity are significantly less physically active (especially older adults). Research on the efficacy and effectiveness of PA in the management of chronic diseases in LMICs is urgently needed. Targeted promotion of physical activity to populations in LMICs experiencing chronic conditions may ameliorate associated depression, mobility difficulties and pain that are themselves important barriers for initiating or adopting an active lifestyle.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-017-0463-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Chronic physical conditions, multimorbidity and physical activity across 46 low- and middle-income countries

Vancampfort

Koyanagi

Ward

et al. 2017

Int J Behav Nutr Phys Act

141

123

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“…A brief culturally adapted version of CBT-p was also linked with improvements in insight 162,163 . Drake et al 164 found that cognitive therapy which followed cognitive remediation was linked to greater improvements in clinical insight in psychosis.…”

Section: Psychological Interventions Which Can Affect Insightmentioning

confidence: 99%

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

et al. 2018

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Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture.

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“…Numerous adjustemnts were required to improve accesability, acceptability and efficiency of CBT [1, 4, 14–16]. Based on this work we have developed a methodology to culturally adapt CBTp that has been described in details elsewhere [15, 17, 18].…”

Section: Introductionmentioning

confidence: 99%

A qualitative study to explore views of patients’, carers’ and mental health professionals’ to inform cultural adaptation of CBT for psychosis (CBTp) in China

Zhang

Luo

et al. 2017

BMC Psychiatry

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BackgroundThe evidence for effectiveness of Cognitive Behaviour Therapy (CBT) is robust and the national organizations in the United Kingdom and the United States recommend its use. It is not utilized to its full potential in low and middle-income countries. Adaptation of CBT treatment to the target culture may facilitate its uptake.This study explored views of patients with schizophrenia, their caregivers, and mental health professionals for the purpose of cultural adaptation of CBT.MethodThe project was conducted in a teaching hospital in China. Systematic content and question analysis were the techniques we used to analyse the data generated in a series of qualitative interviews (N 45) in China. After identification of emerging themes and categories we compared and contrasted the themes across different interviews recursively. Triangulation of themes and concepts was undertaken to compare further and contrast the data from the different participating groups.ResultsThis work highlighted the barriers in therapy as well as opportunities for use of CBT in that environment. Patients and their carers in China use a bio-psycho-spiritual-social model of illness. CBT is not commonly used to help those with schizophrenia in China.ConclusionsThis study will facilitate the therapists using CBT for people with psychosis in China. These results require to be tested in clinical trials.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-017-1290-6) contains supplementary material, which is available to authorized users.

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Brief culturally adapted CBT for psychosis (CaCBTp): A randomized controlled trial from a low income country

Cited by 79 publications

References 29 publications

Chronic physical conditions, multimorbidity and physical activity across 46 low- and middle-income countries

Chronic physical conditions, multimorbidity and physical activity across 46 low- and middle-income countries

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

A qualitative study to explore views of patients’, carers’ and mental health professionals’ to inform cultural adaptation of CBT for psychosis (CBTp) in China

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