Determinants of Duration of Untreated Psychosis and the Pathway to Care in Singapore

Chong, Siow‐Ann; Mythily,; Lum, Alvin; Chan, Yiong Huak; McGorry, Patrick D.

doi:10.1177/0020764005053278

Cited by 70 publications

(72 citation statements)

References 22 publications

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“…Some papers sought to answer more than one question. Six studies explored reasons for treatment delays and barriers in pathways to care in first-episode psychosis (Larsen et al, 1998, Lincoln et al, 1998, Addington et al, 2002, Etheridge et al, 2004, Fuchs and Steinert, 2004, Norman et al, 2004, five explored the influence of ethnicity on pathways (Cole et al, 1995, Burnett et al, 1999, Morgan et al, 2005b, Morgan et al, 2005, Bhugra et al, 2000 Two studies explored social determinants of pathways (Bhugra et al, 2000, Cougnard et al, 2004, one investigated clinical influences on pathways (Cougnard et al, 2004) and two articles examined the relationship between DUP and pathways to care (Larsen et al, 1998, Chong et al, 2005. One paper looked at the usefulness of a pathway to care model and tool (Perkins et al, 1999), one sought to understand help-seeking contacts (Fuchs and Steinert, 2004), one investigated the time point in early psychosis when antipsychotics were initiated (Cougnard et al, 2004) and one paper made cross-national comparison on the epidemiology and presentation of first-episode psychosis (Sartorious et al, 1986)].…”

Section: Study Aimsmentioning

confidence: 99%

“…Most studies came from the UK (Cole et al, 1995, Burnett et al, 1999, Morgan et al, 2005b, Morgan et al, 2005, Bhugra et al, 2000, Etheridge et al, 2004, three were from other European countries (Larsen et al, 1998, Cougnard et al, 2004, Fuchs and Steinert, 2004, three were from North America/Canada (Perkins et al, 1999, Addington et al, 2002, Norman et al, 2004 and one each from Australia (Lincoln et al, 1998) and Singapore (Chong et al, 2005) and one study was multinational (Sartorious et al, 1986). The smallest study had 9 subjects (Perkins et al, 1999) while the largest had 1379 subjects (Sartorious et al, 1986) the mean number of subjects being 210 (SD= 352; mode 86).…”

Section: Study Settings and Populationsmentioning

confidence: 99%

“…(Larsen et al, 1998). One paper defined first help-seeking contact but used no structured assessment of pathways (Chong et al, 2005).…”

Section: Pathways Measure Usedmentioning

confidence: 99%

“…Pathways to care in firstepisode psychosis are highly varied and diverse. Health professionals are the first point of contact for most people experiencing early psychosis (Sartorious et al, 1986, Addington et al, 2002, Cougnard et al, 2004, Etheridge et al, 2004, Fuchs and Steinert, 2004, Norman et al, 2004, Chong et al, 2005, Burnett et al, 1999. Contact with non-statutory agencies such as religious agencies or faith-healers is not common (Sartorious et al, 1986, Chong et al, 2005.…”

Section: Key Findings Related To Pathways To Care (See Table 1)mentioning

confidence: 99%

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Measuring pathways to care in first-episode psychosis: A systematic review

Singh

Grange

2006

Schizophrenia Research

120

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Background: Adequately measuring pathways to care is a prerequisite for early detection and effective treatment of first-episode psychosis. Method:We conducted a systematic review of studies on pathways to care in firstepisode psychosis to establish what measures currently exist to assess pathways in first-episode psychosis and to compare these measures. Results:We identified 15 studies which had used six different measures of pathways to care. Differences in aims, methodology and lack of psychometric data did not allow a direct comparison of pathways measures but certain common themes emerged.Discussion: Pathways to care in first-episode psychosis are diverse and varied. There is no measure with established psychometric properties that has been devised on a well-developed theoretical or conceptual framework and had its psychometric properties established. The conflict between exploring the patient"s narrative and journey through the healthcare system and developing an empirical measure of pathways with optimal outcomes has hindered the development of such a measure.

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Section: Study Aimsmentioning

confidence: 99%

Section: Study Settings and Populationsmentioning

confidence: 99%

“…(Larsen et al, 1998). One paper defined first help-seeking contact but used no structured assessment of pathways (Chong et al, 2005).…”

Section: Pathways Measure Usedmentioning

confidence: 99%

Section: Key Findings Related To Pathways To Care (See Table 1)mentioning

confidence: 99%

See 2 more Smart Citations

Measuring pathways to care in first-episode psychosis: A systematic review

Singh

Grange

2006

Schizophrenia Research

120

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“…While shamanism can be found across times and cultures, it is an interesting phenomenon especially in contemporary societies because it has been utilized alongside psychotherapy and biomedicine for managing mental and physical health (Chong et al 2005;Finkler 2004;Heinze 1997;Kirmayer 2004;Kleinman 1980: Nguyen 2008. This suggests that shamanism may serve certain therapeutic functions that are beyond the reach of modern health care systems.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Processes and Perceived Helpfulness of Dang-Ki (Chinese Shamanism) from the Symbolic Healing Perspective

Lee

Kirmayer

Groleau

2009

Cult Med Psychiatry

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This study focuses on the therapeutic process and perceived helpfulness of dang-ki, a form of Chinese shamanistic healing, in Singapore. It aims to understand the healing symbols employed in dang-ki, whether or not patients find them helpful and whether their perceived helpfulness can be explained by the symbolic healing model (Dow, Am Anthropol 88(1): 56-69, 1986; Levi-Strauss, Structural anthropology. Basic Books, New York, 1963). Although many researchers have applied this model to explain the efficacy of shamanistic healings, they did not directly provide empirical support. Furthermore, the therapeutic process of a shared clinical reality as proposed by the model may be achievable in small-scale traditional societies that are culturally more homogeneous than in contemporary societies that are culturally more diversified due to globalization and immigration. Patients may hold multidimensional health belief systems, as biomedicine and alternative healing systems coexist. Thus, it would be interesting to see the relevance and applicability of the symbolic healing model to shamanistic healing in contemporary societies. In this study, ethnographic interviews were conducted with 21 patients over three stages: immediately before and after the healing and approximately 1 month later. The dang-ki healing symbols were identified by observing the healing sessions with video recording. Results show that dang-kis normally applied more than one method to treat a given problem. These methods included words, talismans and physical manipulations. Overall, 11 patients perceived their consultations as helpful, 4 perceived their consultations as helpful but were unable to follow all recommendations, 5 were not sure of the outcome because they had yet to see any concrete results and only 1 patient considered his consultation unhelpful. Although the symbolic healing model provides a useful framework to understand perceived helpfulness, processes such as enactment of a common meaning system and symbolic transformation are complex and dynamic, and may be carried over several healing sessions.

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Practitioner psychologists' perspectives on working with clients with psychosis in a South‐East Asian city‐state: A qualitative investigation

Wen,

Mankiewicz

2024

Couns and Psychother Res

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ObjectivePrevious qualitative studies have investigated the experiences of undergoing an evidence‐based psychotherapy for psychosis among individuals affected by such condition. However, the literature investigating the perspectives, experiences and needs of psychological practitioners providing the treatment remains considerably underrepresented. In the context of Asian cultures, where pervasive stigma towards psychosis and mental health services exists and interferes with proactive help‐seeking, such research appears even more pertinent. To address the gap in the existing literature, this study utilised qualitative methodology to investigate the experiences of practitioner psychologists working with clients with psychosis in a South‐East Asian city‐state.MethodSix fully qualified participants were recruited from the local mental health services via convenience sampling. Semi‐structured qualitative interviews were conducted. Transcribed verbatim data were then subjected to inductive thematic analysis.ResultsFour superordinate themes emerged, as follows: therapeutic alliance, cognitive behavioural therapy for psychosis (CBTp) as primary approach, cultural influences and needs of practitioners.ConclusionsResults indicated that both practitioner psychologists and their clients contributed collaboratively to the establishment of therapeutic alliance. Although CBTp was utilised as a principal psychotherapeutic approach, acceptance and commitment therapy (ACT) was also valued. Necessary adaptations in the treatment were reflected on to address the specificity of local cultures, including the use of language and addressing pervasive public stigma. The necessity of multidisciplinary collaboration, localised training and supervision was also expressed.

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Determinants of Duration of Untreated Psychosis and the Pathway to Care in Singapore

Abstract: The DUP of our patients was longer than that reported in studies done in the West. The attitudes and beliefs of family in the Asian society are likely to be crucial in the pathways to care.

Cited by 70 publications

References 22 publications

Measuring pathways to care in first-episode psychosis: A systematic review

Measuring pathways to care in first-episode psychosis: A systematic review

Therapeutic Processes and Perceived Helpfulness of Dang-Ki (Chinese Shamanism) from the Symbolic Healing Perspective

Practitioner psychologists' perspectives on working with clients with psychosis in a South‐East Asian city‐state: A qualitative investigation

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