Twenty-Year Course of Schizophrenia: The Madras Longitudinal Study

Rangaswamy, Thara

doi:10.1177/070674370404900808

Cited by 106 publications

(69 citation statements)

References 19 publications

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“…25 A 20-year follow-up study of the Indian cohort in the 10-nation study also showed very high level of mortality. 26 The question as to how a better symptomatic outcome at 2-year follow-ups translated to poor mortality outcomes at 5 and 20 years is an open one.…”

Section: Outcome Of Schizophreniamentioning

confidence: 99%

Psychiatry in Africa: the myths, the exotic, and the realities

Gureje

2007

Afr. J. Psych

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Information regarding the occurrence and nature of mental disorders in Africa is still grossly limited. For many years, anecdotal reports and personal views, many of them based on very limited data, prevailed. Subsequently, many early studies were based on clinical samples and thus limited in generalizability. These factors led to a number of myths about mental disorders among Africans. In this short review, some of these myths are examined in the light of current information. It is observed that sufficient information probably exists to discard some old myths while some other current views, even though suspect in regard to their validity, await further exploration. It is concluded that while some racial differences may have been mistaken, there nevertheless remains the possibility that some unique features of psychiatric and behavioural disorders in Africans offer the prospect of advancing our knowledge in regard to etiology and possible interventions.

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Section: Outcome Of Schizophreniamentioning

confidence: 99%

Psychiatry in Africa: the myths, the exotic, and the realities

Gureje

2007

Afr. J. Psych

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“…21 This same pattern was found at the 20-year followup. 16 Furthermore, as noted above, this cohort was subjected to high rates of mortality and suicide.…”

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confidence: 96%

“…Suicidesall by persons younger than 35 years -accounted for nearly half of all deaths (7 of 16). 16 The paradox of a better symptomatic outcome in developing countries was also exemplified in the results of the earlier IPSS. 17 Even though a better 2-year clinical outcome was reported for patients from developing countries, at the 5-year follow-up, the percentages of patients in Agra (India) and Ibadan (Nigeria) who had died were 9.0 and 7.1, respectively, compared with 4.9% for the entire study cohort.…”

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confidence: 98%

Is the outcome of schizophrenia really better in developing countries?

Patel

Cohen

Rangaswamy

et al. 2006

Rev. Bras. Psiquiatr.

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A b s t r a c t That schizophrenia has a better prognosis in non-industrialized societies has become an axiom in international psychiatry; the evidence most often cited comes from three World Health Organization (WHO) cross-national studies. Although a host of sociocultural factors have been considered as contributing to variation in the course of schizophrenia in different settings, we have little evidence from low-income countries that clearly demonstrates the beneficial influence of these variables. In this article, we suggest that the finding of better outcomes in developing countries needs re-examination for five reasons: methodological limitations of the World Health Organization studies; the lack of evidence on the specific socio-cultural factors which apparently contribute to the better outcomes; increasing anecdotal evidence describing the abuse of basic human rights of people with schizophrenia in developing countries; new evidence from cohorts in developing countries depicting a much gloomier picture than originally believed; and, rapid social and economic changes are undermining family care systems for people with schizophrenia in developing countries. We argue that the study of the long-term course of this mental disorder in developing countries is a major research question and believe it is time to thoroughly and systematically explore cross-cultural variation in the course and outcome of schizophrenia.Keywords: Schizophrenia; Cross-cultural comparison; Developing countries; Human rights abuses; Prognosis Resumo O fato de que a esquizofrenia possui um melhor prognóstico em sociedades não industrializadas tornou-se um axioma na psiquiatria internacional; as evidências mais comumente citadas provêm de três estudos trans-nacionais da Organização Mundial da Saúde (OMS). Ainda que um conjunto de fatores socioculturais tenha sido considerado como contribuinte para o curso da esquizofrenia em diferentes ambientes, possuímos poucas evidências de países de baixa renda que demonstrem claramente a influência benéfica dessas variáveis. Neste artigo, sugerimos que o achado de melhores desfechos em países em desenvolvimento necessita ser reexaminado por cinco razões: falhas fundamentais nos estudos da Organização Mundial da Saúde; a falta de evidências sobre os fatores socioculturais específicos que contribuem aparentemente para os melhores desfechos; as crescentes evidências incidentais que descrevem o abuso dos direitos humanos das pessoas portadoras de esquizofrenia nos países em desenvolvimento; novas evidências de coortes em países em desenvolvimento descrevendo um quadro muito mais sombrio do que se pensava originalmente; e as rápidas transformações sociais e econômicas estão enfraquecendo os sistemas de atenção familiares para pessoas com esquizofrenia nos países em desenvolvimento. Afirmamos que o estudo do curso de longo prazo desse transtorno mental é fundamental e acreditamos que é tempo de explorar completa e sistematicamente a variação transcultural no curso e no desfecho da esquizofrenia.

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“…Si bien esta idea ha sido discutida 40 , la hipótesis sociocultural ha generado un interesante campo de investigación para epidemió-logos y etnógrafos 41,42 . Hoy por hoy podemos hablar de cuatro líneas de estudio que, si bien no son excluyentes ni contradictorias entre sí, pueden descomponerse a efectos analíticos.…”

Section: El Dilema De La Diferencia En El Pronóstico De Enfermedades unclassified

Cuando las hormigas corretean por el cerebro: retos y realidades de la psiquiatría cultural

Martínez-Hernáez

2006

Cad. Saúde Pública

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IntroducciónEl título de este artículo es una traducción adaptada de una expresión Igbo (Nigeria), utilizada por este grupo étnico para denotar el malestar somático característico de los trastornos mentales 1 : "things like ants keep on creeping in various parts of my brain". Se trata de un idiom of distress o expresión de malestar que permite que el lector se ubique en la posición del clíni-co, epidemiólogo e investigador que debe trabajar con interlocutores ajenos a su cultura. ¿Qué significa esta frase? ¿A qué realidades de malestar y aflicción nos está remitiendo? ¿Po-demos traducir esta expresión a otros lenguajes no sólo idiomáticos, sino también culturales? ¿Nos habla de un tipo de experiencia que ya nos es conocida o nos enfrenta a formas de sufrimiento que sólo adquieren consistencia en un determinado mundo local?Las preguntas que generan los idioms of distress han sido durante largo tiempo objeto de estudio de la psiquiatría transcultural, así como de la más contemporánea psiquiatría cultural. En términos descriptivos podemos decir que la primera ha sido a la investigación en territorios no-occidentales durante el periodo colonial y postcolonial, como la segunda al análi-sis de las minorías étnicas en contextos nacionales de multiculturalidad; aunque esta distinción no sea siempre operativa debido a las diferencias terminológicas según autores, escue-

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Twenty-Year Course of Schizophrenia: The Madras Longitudinal Study

Cited by 106 publications

References 19 publications

Psychiatry in Africa: the myths, the exotic, and the realities

Psychiatry in Africa: the myths, the exotic, and the realities

Is the outcome of schizophrenia really better in developing countries?

Cuando las hormigas corretean por el cerebro: retos y realidades de la psiquiatría cultural

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