Early intervention in schizophrenia in developing countries: Focus on duration of untreated psychosis and remission as a treatment goal

Chiliza, Bonginkosi; Asmal, Laila; Emsley, Robin

doi:10.3109/09540261.2012.704873

Cited by 25 publications

(20 citation statements)

References 33 publications

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“…A previous review suggested that the correlation between DUP and outcome in developing countries was somewhat contradictory as the DUP tended to be longer but remission rates were higher, despite some correlation between long DUP and poor outcome. 33 Our meta-analysis gives only limited information on differences between countries based on the level of income. There was no study from a low-income country and only a few (from none to four) studies from countries with lower- or higher-middle level of income in each of the outcome categories.…”

Section: Discussionmentioning

confidence: 99%

Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis

et al. 2014

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“…Both findings have public health significance. Long durations of untreated psychosis have been reported in Sub-Saharan Africa compared to high income countries and have been associated with poorer outcomes [54][55][56]. Late onset of psychotic illnesses is often associated with a less severe course and better outcomes [57].…”

Section: Age Of Initial Presentation With a First Episode Of Psychosismentioning

confidence: 99%

One year prevalence of psychotic disorders among first treatment contact patients at the National Psychiatric Referral and Teaching Hospital in Uganda

et al. 2020

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Introduction Hospital based studies for psychotic disorders are scarce in low and middle income countries. This may impact on development of intervention programs. Objective We aimed to determine the burden of psychotic disorders among first treatment contact patients at the national psychiatric referral hospital in Uganda. Methods A retrospective patient chart-file review was carried out in March 2019 for all patients presenting to the hospital for the first time in the previous year. Patients were categorised into those with and without psychotic disorders. We collected sociodemographic data on age, gender, occupation, level of education, ethnicity, religion and home district. We determined the one year prevalence of psychotic disorders among first treatment contact patients. Using logistic regression models, we also determined the association between psychotic disorders and various exposure variables among first treatment contact patients. Results In 2018, 63% (95% CI: 60.2-65.1) of all first time contact patients had a psychosis related diagnosis. Among the patients with psychotic disorders, the median age was 29 years (IQR 24-36). Most of the patients were male (62.8%) and unemployed (63.1%). After adjusting for patients' residence, psychotic disorders were found to be more prevalent among the female gender [OR 1.58 (CI1.46-1.72)] and those of Pentecostal faith [OR 1.25 (CI 1.10-1.42)].

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“…Basic symptoms consist of subclinical subtle disturbances in stress tolerance, affect, thinking, speech, drive, perception and motor action [ 8 , 9 ] appearing before the appearance of APS or BLIPS, thus allowing for detection of at risk patients at an earlier stage. There is accumulating evidence that the onset of psychosis can be prevented by intervening in this risk phase [ 10 – 12 ] and treatment in the early stages of schizophrenia is critical to the progression of the disease [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

Social Cognition in Individuals at Ultra-High Risk for Psychosis: A Meta-Analysis

et al. 2015

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ObjectiveTreatment in the ultra-high risk stage for a psychotic episode is critical to the course of symptoms. Markers for the development of psychosis have been studied, to optimize the detection of people at risk of psychosis. One possible marker for the transition to psychosis is social cognition. To estimate effect sizes for social cognition based on a quantitative integration of the published evidence, we conducted a meta-analysis of social cognitive performance in people at ultra high risk (UHR).MethodsA literature search (1970-July 2015) was performed in PubMed, PsychINFO, Medline, Embase, and ISI Web of Science, using the search terms ‘social cognition’, ‘theory of mind’, ‘emotion recognition’, ‘attributional style’, ‘social knowledge’, ‘social perception’, ‘empathy’, ‘at risk mental state’, ‘clinical high risk’, ‘psychosis prodrome’, and ‘ultra high risk’. The pooled effect size (Cohen’s D) and the effect sizes for each domain of social cognition were calculated. A random effects model with 95% confidence intervals was used.ResultsSeventeen studies were included in the analysis. The overall significant effect was of medium magnitude (d = 0.52, 95% Cl = 0.38–0.65). No moderator effects were found for age, gender and sample size. Sub-analyses demonstrated that individuals in the UHR phase show significant moderate deficits in affect recognition and affect discrimination in faces as well as in voices and in verbal Theory of Mind (TOM). Due to an insufficient amount of studies, we did not calculate an effect size for attributional bias and social perception/ knowledge. A majority of studies did not find a correlation between social cognition deficits and transition to psychosis, which may suggest that social cognition in general is not a useful marker for the development of psychosis. However some studies suggest the possible predictive value of verbal TOM and the recognition of specific emotions in faces for the transition into psychosis. More research is needed on these subjects.ConclusionThe published literature indicates consistent general impairments in social cognition in people in the UHR phase, but only very specific impairments seem to predict transition to psychosis.

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Early intervention in schizophrenia in developing countries: Focus on duration of untreated psychosis and remission as a treatment goal

Cited by 25 publications

References 33 publications

Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis

Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis

One year prevalence of psychotic disorders among first treatment contact patients at the National Psychiatric Referral and Teaching Hospital in Uganda

Social Cognition in Individuals at Ultra-High Risk for Psychosis: A Meta-Analysis

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