Incidence of first-contact psychosis in São Paulo,
                        Brazil

Menezes, Paulo Rossi; Scazufca, Márcia; Busatto, Geraldo F.; Coutinho, Letícia Maria Silva; McGuire, Philip; Murray, Robin M.

doi:10.1192/bjp.191.51.s102

Cited by 73 publications

(84 citation statements)

References 24 publications

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“…They are at the upper end of rates reported in previous studies in low-and middle-income settings (see Table 1), including those that have used the most comparable methods. For example, studies in Brazil (Menezes et al 2007), Trinidad (Bhugra et al 1996), and Barbados (Mahy et al 1999) that applied the same inclusion criteria reported rates between 15 and 35/1 00 000 per year. It is notable that the highest reported rate is from the study in Barbados, whichas far as we could ascertain -was the only one that sought to extend case-finding to religious institutions.…”

Section: Psychoses Elsewherementioning

confidence: 99%

“…It is unclear to what extent the apparent association between the incidence of psychoses and population density extends beyond the northern European cities in which it has been reported. Menezes et al (2007), for example, found a low rate of around 15/1 00 000 in a catchment area in Sao Paulo, one of the most densely populated cities in the world. The association, then, between psychoses and population density may be more complex than research to date suggests; investigating this further in a wider range of cities, across different continents, may provide novel insights into the kinds of environments that foster the development of psychoses.…”

Section: Psychoses Elsewherementioning

confidence: 99%

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The incidence of psychoses in diverse settings, INTREPID (2): a feasibility study in India, Nigeria, and Trinidad

et al. 2016

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Background. There are striking global inequities in our knowledge of the incidence, aetiology, and outcome of psychotic disorders. For example, only around 10% of research on incidence of psychotic disorders originates in low-and middleincome countries. We established INTREPID I to develop, implement, and evaluate, in sites in India (Chengalpet), Nigeria (Ibadan), and Trinidad (Tunapuna-Piarco), methods for identifying and recruiting untreated cases of psychosis, as a basis for investigating incidence and, subsequently, risk factors, phenomenology, and outcome. In this paper, we compare case characteristics and incidence rates across the sites.Method. In each site, to identify untreated cases of psychoses in defined catchment areas, we established case detection systems comprising mental health services, traditional and spiritual healers, and key informants.Results. Rates of all untreated psychoses were 45.9 (per 1 00 000 person-years) in Chengalpet, 31.2 in Ibadan, and 36.9 in Tunapuna-Piarco. Duration of psychosis prior to detection was substantially longer in Chengalpet (median 232 weeks) than in Ibadan (median 13 weeks) and Tunapuna-Piarco (median 38 weeks). When analyses were restricted to cases with a short duration (i.e. onset within preceding 2 years) only, rates were 15.5 in Chengalpet, 29.1 in Ibadan, and 26.5 in Tunapuna-Piarco. Further, there was evidence of age and sex differences across sites, with an older average age of onset in Chengalpet and higher rates among women in Ibadan.Conclusion. Our findings suggest there may be differences in rates of psychoses and in the clinical and demographic profiles of cases across economically and socially distinct settings.

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Section: Psychoses Elsewherementioning

confidence: 99%

Section: Psychoses Elsewherementioning

confidence: 99%

The incidence of psychoses in diverse settings, INTREPID (2): a feasibility study in India, Nigeria, and Trinidad

et al. 2016

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“…Schizophrenia is currently believed to be caused by a combination of genetic and environmental factors, which establish complex interactions during brain development 1,2 . The natural history of schizophrenia usually involves a prodromal period, when mild symptoms progressively increase in severity, duration and frequency until crossing a threshold, then allowing a diagnosis to be established in light of current nosological classification systems 3 .…”

Section: Introductionmentioning

confidence: 99%

Early intervention in psychosis: a map of clinical and research initiatives in Latin America

Brietzke

Neto

Dias

et al. 2011

Rev. Bras. Psiquiatr.

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Objective: This article aims to review Latin America's early intervention services in psychosis and to shed light into their challenges and particularities. Method: An internet-based search comprising medical societies' websites, published articles, and major universities' websites was conducted and the results were critically discussed. Results: Latin American countries are profoundly deficient in specialized early intervention services. Our search found seven target services, four of which are based in urban areas of Brazil, inside tertiary hospitals or universities. Among the initiatives advanced by these centers, there are partnerships with the public educational system and other community-based efforts toward knowledge transfer. On the other hand, several challenges remain to be overcome, especially in relation to their expansion, which is necessary to match the existing demand. Descriptors

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“…1 In many countries psychiatric emergency services are frequently the first contact patients have with the health system or the main source of referral for the treatment of first-episode psychosis. 2 In Brazil, a study performed in the city of São Paulo showed that emergency services were the first contact of the patient with the health system in around 70% of the cases of first-episode psychosis, 3 and in around 50% of the cases this contact is made within up to four weeks of the onset of psychotic symptoms. 4 Some characteristics inherent to psychiatric emergency care may affect diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 99%

Diagnóstico diferencial de primeiro episódio psicótico: importância da abordagem otimizada nas emergências psiquiátricas

Del-Ben

Rufino

Marques

et al. 2010

Rev. Bras. Psiquiatr.

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Objective: To review the literature regarding the diagnosis of first-episode psychosis in the context of psychiatric emergency. Method: Review of empirical and review articles selected by electronic search in the PubMed database. Results: Specific features of emergency care -single, brief, and cross-sectional assessments with little information -may jeopardize the diagnostic process. These limitations can be circumvented by the application of operational diagnostic criteria, by the use of scales and structured interviews, and by short observation periods (24-72 hours). Diagnoses of bipolar disorder, schizophrenia, psychotic depression, and delusional disorder performed in the context of emergency have good stability, but the same does not apply to the diagnoses of brief psychotic disorder, schizophreniform disorder, and schizoaffective disorder. Firstepisode psychosis can occur in the course of the use of psychoactive substances and the persistence of psychotic symptoms even after cessation of the use of the substance is relatively frequent. The rational use of subsidiary tests may be of help in establishing the differential diagnosis of psychotic episodes due to general medical conditions. Conclusion: The diagnosis of first-episode psychosis can be adequately performed by psychiatric emergency services if evidence-based routines are implemented. Descriptors

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Incidence of first-contact psychosis in São Paulo, Brazil

Abstract: Incidence of psychosis in São Paulo was lower than expected for a large metropolis.

Cited by 73 publications

References 24 publications

The incidence of psychoses in diverse settings, INTREPID (2): a feasibility study in India, Nigeria, and Trinidad

The incidence of psychoses in diverse settings, INTREPID (2): a feasibility study in India, Nigeria, and Trinidad

Early intervention in psychosis: a map of clinical and research initiatives in Latin America

Diagnóstico diferencial de primeiro episódio psicótico: importância da abordagem otimizada nas emergências psiquiátricas

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