The association between duration of untreated psychosis in first psychotic episode patients and help seeking behaviors in Jogjakarta, Indonesia

Abstract

Help seeking is predictor of prognosis in the first episode of psychotic disorders. Caregivers play a key role in deciding from whom to seek help. In Indonesia, caregivers often seek help from alternative healers first and health professionals later, which is believed to result in delayed psychiatric treatment and risk for poor prognosis. This study measured the duration of untreated psychosis (DUP) in a sample of 100 persons being treated for a first episode of psychosis in Yogyakarta, Indonesia. We attempted to measure and determine associations among caregivers’ explanatory models, help seeking behaviors and DUP in this sample. The data were then statistically analyzed. The DUP for this population was very short. Most caregivers were parents or spouses (72 and 12%, respectively) and at the time of being interviewed described medical explanatory models for the psychotic symptoms (60%). A majority described having visited traditional/alternative healers prior to their visit to health professionals (67%). Despite this, the DUP was not significantly different for these two groups. Thus, first resort to traditional/alternative healers did not predict prolonged DUP. Further study with a larger sample is needed to better understand the relationship between care seeking, use of alternative healers and DUP in Indonesia.

Health-Seeking Behavior of People in Indonesia: A Narrative Review

“…Fifty-six peer-reviewed articles were found from 1987 to 2017 [21][22][23], and 19 articles from Indonesian journals from 2001 to 2016 [78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96]. Looking at the publication dates, health-seeking behavior in Indonesia drew little attention before 2000, with only six articles before that time.…”

“…Indonesian people's choice of health providers is determined by complex and interrelated factors: sociodemographic characteristics, influence of significant others, sociocultural beliefs, perception about diseases and their causality, and perception of medical services including accessibility and availability, particularly in rural and areas, and its related cost [23,[28][29][30]34,35,38,[40][41][42][45][46][47][48]52,[54][55][56][57]59,60,64,65,67,72].…”

“…It has been the focus of numerous studies in developing countries [13][14][15][16][17][18][19][20]. Other terms with similar meaning include treatment-, care-, and help-seeking behavior [21][22][23].…”

Brief interactive psychoeducation for caregivers of patients with early phase psychosis in Yogyakarta, Indonesia

“…Although Javanese families often play a significant role in the management of patients with psychotic disorders, our previous studies have shown that they hold different explanatory models for the disorders and for recovery than those of health practitioners (Good & Subandi, 2004;Marchira, Puspitasari, Mulyani, & Rochmawati, 2016;Marchira, Supriyanto, Subandi, & Good, 2016). Discrepancies in understanding of illness and treatment between caregivers and health practitioners have been shown in many studies (Jorm, Angermeyer, & Katschnig, 2000;Riedel-Heller, Matschinger, & Angermeyer, 2005;Wright, Harris, Wiggers, & Jorm, 2005).…”

The Heart of the Meaning: Honoring the Work of Byron J. Good

“…Dr Good's book, edited with psychiatrist Devon Hinton, Panic Disorders (2009) is a landmark in the study of that (or those) condition (88). As well, we note that rather than prejudging a condition, thus westernizing it, he, and DelVecchio Good have studied undefined ''psychoses'' or ''madness'' rather than 'schizophrenia' (e.g., 83,90,92,94,116,120). A recent work, Culture and PTSD, also edited with Devon Hinton, considers issues taken up earlier, the facts of violence and trauma and their influence on daily life and on forms of affliction in specific contexts (113,114,118).…”