Developing countries: The outcomes paradox

Padma, T. V.

doi:10.1038/508s14a

Cited by 16 publications

(8 citation statements)

References 4 publications

(2 reference statements)

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“…It would also be highly informative to investigate whether the current findings are generalizable to other countries with less developed welfare systems, in particular as better relative outcome in schizophrenia patients have been reported from developing countries. 31 Moreover, as premorbid cognitive dysfunction has been reported for individuals suffering from schizophrenia, it would be of great interest to include cognitive measures indexed before illness onset in the current analyses, to shed further light on the relation between schizophrenia, educational attainment and mortality. 15 In addition to a higher load of well‐known CVD risk factors, shared genetic risk 8 as well as adverse effects of antipsychotic medication could contribute to premature death in schizophrenia, independently of educational attainment/SEP.…”

Section: Discussionmentioning

confidence: 99%

Educational attainment and mortality in schizophrenia

Tesli

Degerud

Plana‐Ripoll

et al. 2022

Acta Psychiatr Scand

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Background: Individuals suffering from schizophrenia have a reduced life expectancy with cardiovascular disease (CVD) as a major contributor. Low educational attainment is associated with schizophrenia, as well as with all-cause and CVD mortality. However, it is unknown to what extent low educational attainment can explain the increased mortality in individuals with schizophrenia. Aim: Here, we quantify associations between educational attainment and allcause and CVD mortality in individuals with schizophrenia, and compare them with the corresponding associations in the general population.

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Section: Discussionmentioning

confidence: 99%

Educational attainment and mortality in schizophrenia

Tesli

Degerud

Plana‐Ripoll

et al. 2022

Acta Psychiatr Scand

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“…140,147,155 This would indirectly imply that treatment-naïve patients might do better long-term, but subsequent publications rejected this more favorable outcome. [156][157][158][159] Maybe, the most important finding of that study was that the time spent in episodes of psychosis during the early illness stages is a strong determinant of later adverse outcomes, thus supporting the long-term beneficial effect of early and sufficient medication treatment. 140 A number of projects, including the AESOP-10, 149,150 the Suffolk County Mental Health Project, 146 and the Chicago Follow-up studies, [141][142][143][144] failed to provide data and conclusions free of the well-known biases of naturalistic and observational studies.…”

Section: Question 2: Should Antipsychotics Be Used In First-episode Patients?mentioning

confidence: 84%

The report of the joint WPA/CINP workgroup on the use and usefulness of antipsychotic medication in the treatment of schizophrenia

et al. 2020

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This is a report of a joint World Psychiatric Association/International College of Neuropsychopharmacology (WPA/CINP) workgroup concerning the risk/benefit ratio of antipsychotics in the treatment of schizophrenia. It utilized a selective but, within topic, comprehensive review of the literature, taking into consideration all the recently discussed arguments on the matter and avoiding taking sides when the results in the literature were equivocal. The workgroup’s conclusions suggested that antipsychotics are efficacious both during the acute and the maintenance phase, and that the current data do not support the existence of a supersensitivity rebound psychosis. Long-term treated patients have better overall outcome and lower mortality than those not taking antipsychotics. Longer duration of untreated psychosis and relapses are modestly related to worse outcome. Loss of brain volume is evident already at first episode and concerns loss of neuropil volume rather than cell loss. Progression of volume loss probably happens in a subgroup of patients with worse prognosis. In humans, antipsychotic treatment neither causes nor worsens volume loss, while there are some data in favor for a protective effect. Schizophrenia manifests 2 to 3 times higher mortality vs the general population, and treatment with antipsychotics includes a number of dangers, including tardive dyskinesia and metabolic syndrome; however, antipsychotic treatment is related to lower mortality, including cardiovascular mortality. In conclusion, the literature strongly supports the use of antipsychotics both during the acute and the maintenance phase without suggesting that it is wise to discontinue antipsychotics after a certain period of time. Antipsychotic treatment improves long-term outcomes and lowers overall and specific-cause mortality.

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“…For instance, The World Psychiatric Association (WPA) Task Force, initiated activities aiming to support psychiatry journals (e.g. with PubMed indexation) in LAMI countries , the Grand Challenges in Global Mental Health initiative by the US National Institute of Mental Health has identified research priorities to impact on mental health internationally , The WHO-launched collaborative longitudinal study of schizophrenia (Padma, 2014), and the Grand Challenges in Global Mental Health initiatives The current mapping study is the first to review lacking diagnostic scale availability in early assessment of childhood ASD for research purposes from a cross-national perspective.…”

Section: Discussionmentioning

confidence: 99%

Challenges and Inequalities of Opportunities in European Psychiatry Research

Bölte

Tomalski

Marschik

et al. 2018

European Journal of Psychological Assessment

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Abstract. Europe is diverse in terms of economy, cultures, socio-demography, and languages. A crucial aspect of psychiatric research is the availability of standardized screening, diagnostic, and characterization instruments. We fine-mapped the accessibility of 14 clinical scales and cognitive tests for the assessment of early childhood Autism Spectrum Disorder (ASD; e.g., ADOS, ADI-R, SCQ, SRS, CHAT, MESL) within 21 European countries. These tools are essential for internationally competitive early ASD detection research. We identified a considerable variation not only in the availability, but also psychometric standardization, and formal distribution of the instruments between the countries, privileging English speaking, high-income, and highly populated European countries. Absence of country-specific standardization was a problem across many countries, independent of income and size. Findings demonstrate, on a concrete level, the challenges in creating equal early ASD identification research opportunities in Europe, and the need for increased funding for instrument development and validation. We discuss the reasons, implications, and consequences of this inequity and ways of reducing it.

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Developing countries: The outcomes paradox

Cited by 16 publications

References 4 publications

Educational attainment and mortality in schizophrenia

Educational attainment and mortality in schizophrenia

The report of the joint WPA/CINP workgroup on the use and usefulness of antipsychotic medication in the treatment of schizophrenia

Challenges and Inequalities of Opportunities in European Psychiatry Research

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