What Is the Best Approach to Treating Schizophrenia in Developing Countries?

Patel, Vikram; Farooq, Saeed; Rangaswamy, Thara

doi:10.1371/journal.pmed.0040159

Cited by 40 publications

(27 citation statements)

References 30 publications

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“…Used in four of the included studies, interpersonal psychotherapy (IPT) reviews a person's current social ties focusing on four social problem areas to improve relationships associated with the onset or perpetuation of mental disorders (Krupnick et al, 2008). Four studies evaluated multicomponent community care interventions, combining psychosocial therapies in a community-based setting where non-specialist human resources are utilised to reduce constraints on low-resourced health systems (Patel, Farooq, & Thara, 2007). Assertive community treatment (ACT) was used in two included studies, which is a social skill training that includes elements of culturally/context-appropriate assertive behaviours targeting behavioural, cognitive, emotive components of social skills (Marks, 1986).…”

Section: Study Characteristicsmentioning

confidence: 99%

Effectiveness of knowledge translation of social interventions across economic boundaries: a systematic review

Newlin

Webber

2015

European Journal of Social Work

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There is increasing evidence to suggest that the application of knowledge in lowand middle-income countries (LMIC) is failing, that a gap exists between what is known from research and what is done to apply it. Despite widespread agreement that the application of evidence is needed, there are few published studies of how to effectively translate knowledge of social interventions, particularly those aimed at improving outcomes for mental health populations. To address this gap we assessed knowledge translation of social interventions for adults with mental health problems across economic boundaries using a systematic review of peer-reviewed literature. This review aimed to identify the extent of translational research available and to explore the effectiveness of different strategies and interventions. Studies were included if they translated knowledge between richer and poorer countries and reported a social component (as opposed to purely health) which aimed to improve social outcomes for adults with mental health problems. Our findings provide evidence for the successful translation of locally adapted social interventions to LMIC, though the specific knowledge translation mechanisms varied greatly. With only 23 studies meeting inclusion criteria for this review, further investigation is needed to ascertain the conditions surrounding knowledge translation of social interventions globally.

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Section: Study Characteristicsmentioning

confidence: 99%

Effectiveness of knowledge translation of social interventions across economic boundaries: a systematic review

Newlin

Webber

2015

European Journal of Social Work

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“…A DOTS strategy has been proposed and is being evaluated for managing patients with schizophrenia in resourcepoor countries, with a focus on regular supplies of antipsychotic medication and supervision of drug administration [25]. A master card system and patient register has been developed for monitoring outcomes in asthma [11] and smoking cessation services [26].…”

Section: Should the Dots Paradigm Be Adapted For Ncds?mentioning

confidence: 99%

Adapting the DOTS Framework for Tuberculosis Control to the Management of Non-Communicable Diseases in Sub-Saharan Africa

Harries¹,

Jahn²,

Zachariah³

et al. 2008

SciVee

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“…involvement of non-psychiatric staff, non-medical staff (e.g. nurses), and low dose neuroleptic treatment in the community [13,14]. In spite of initial attempts to implement community-based or non-specialist care for schizophrenia [15-17] the implementation keeps facing huge challenges [3,18-20].…”

Section: Introductionmentioning

confidence: 99%

A pilot study on community-based outpatient treatment for patients with chronic psychotic disorders in Somalia: Change in symptoms, functioning and co-morbid khat use

Odenwald

Lingenfelder

Peschel

et al. 2012

Int J Ment Health Syst

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BackgroundIn Low and Middle Income Countries, mental health services are often poorly developed due to the lack of resources and trained personnel. In order to overcome these challenges, new ways of care have been suggested such as a focus on community-based services. In Somalia, the consumption of the natural stimulant khat is highly prevalent, aggravating mental illness. At the same time, mental health care is largely unavailable to the vast majority of the population. In a pilot project, we tested possibilities for effective measures in community-based out-patient mental health care.MethodsThirty-five male patients with chronic psychotic disorders and their carers were involved in a 10-months follow-up study. All of them abused khat. Seventeen outpatients experiencing acute psychotic episodes were recruited from the community and received an intensive six week home-based treatment package. Additionally eighteen patients with chronic psychotic disorders in remission were recruited either following hospital discharge or from the community. In a second phase of the study, both groups received community-based relapse prevention that differed in the degree of the family’s responsibility for the treatment. The treatment package was comprised of psycho-education, low-dose neuroleptic treatment, monthly home visits and counseling. The Brief Psychiatric Rating Scale (BPRS) was applied three times. Additionally, we assessed functioning, khat use and other outcomes.ResultsOf the 35 patients enrolled in the study, 33 participated in the 10-month follow-up. Outpatients improved significantly in the first six weeks of treatment and did not differ from remitted patients at the start of the second treatment phase. In the preventive treatment phase, we find heterogeneous outcomes that diverge between symptom and functioning domains. With the exception of depressive symptoms, symptoms in all patients tended to worsen. The outpatient group had higher BPRS positive and negative symptom scores compared to the remitted group. Levels of functioning in 20 out of 33 patients significantly improved, with small differences between groups. Most patients experienced improvements in basic functioning, such as communication, self-care etc. Khat use could only be reduced in the group of outpatients.ConclusionsCommunity-based out-patient mental health treatment for chronic psychotic disorders has demonstrated positive effects in Somalia and is both feasible and practical, despite facing formidable challenges, e.g. controlling khat intake.

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What Is the Best Approach to Treating Schizophrenia in Developing Countries?

Cited by 40 publications

References 30 publications

Effectiveness of knowledge translation of social interventions across economic boundaries: a systematic review

Effectiveness of knowledge translation of social interventions across economic boundaries: a systematic review

Adapting the DOTS Framework for Tuberculosis Control to the Management of Non-Communicable Diseases in Sub-Saharan Africa

A pilot study on community-based outpatient treatment for patients with chronic psychotic disorders in Somalia: Change in symptoms, functioning and co-morbid khat use

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