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Schizophrenia outcome measures in the wider international community

  • Mohan Isaac (a1), Prabhat Chand (a2) and Pratima Murthy (a2)
Abstract
Background

Outcome of schizophrenia has been described as favourable in low-and middle-income countries. Recently, researchers have questioned these findings

Aims

To examine the outcome studies carried out in different countries specifically looking atthose from low-and middle-income countries

Methods

Long-term course and outcome studies in schizophrenia were reviewed

Results

A wide variety of outcome measures are used. The most frequent are clinical symptoms, hospitalisation and mortality (direct indicators), and social/ occupational functioning, marriage, social support and burden of care (indirect indicators). Areas such as cognitive function, duration of untreated psychosis, quality of life and effect of medication have not been widely studied in low-and middle-income countries

Conclusions

The outcome of schizophrenia appears to be better in low-and middle-income countries. A host of sociocultural factors have been cited as contributing to this but future research should aim to understand this better outcome. There is a need for more culture-specific instruments to measure outcomes

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Copyright
Corresponding author
Dr Mohan Isaac, Community, Culture and Mental Health Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, 16 The Terrace, Fremantle, WA 6160, Australia. Email: Mohan.Isaac@uwa.edu.au
Footnotes
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Declaration of interest

None.

Footnotes
References
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American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). APA.
Andreasen, N. C. (1983) The Scale For Assessment Of Negative Symptoms. University of Iowa.
Andreasen, N. C. (1984) The Scale For Assessment Of Positive Symptoms. University of Iowa.
Birchwood, M., Smith, J., Cochrane, R., et al (1990) The Social Functioning Scale. The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. British Journal of Psychiatry, 157, 853859.
Burns, T. (2007) Hospitalisation as an outcome measure in schizophrenia. British Journal of Psychiatry, 191 (suppl. 50), s37s41.
Carey, K. B., Carey, M. P. & Chandra, P. S. (2003) Psychometric evaluation of the alcohol use disorders identification test and short drug abuse screening test with psychiatric patients in India. Journal of Clinical Psychiatry, 64, 767774.
Drake, R. J., Haley, C. J., Akhtar, S., et al (2000) Causes and consequences of duration of untreated psychosis in schizophrenia. British Journal of Psychiatry, 177, 511515.
Ganev, K., Onchev, G. & Ivanov, P. (1998) A 16-year follow-up study of schizophrenia and related disorders in Sofia, Bulgaria. Acta Psychiatrica Scandinavica, 98, 200207.
Gater, R., de Almeida e Sousa, B., Barrientos, G., et al (1991) The pathways to psychiatric care: a cross-cultural study. Psychological Medicine, 21, 761774.
Harrison, G., Hopper, K., Craig, T., et al (2001) Recovery from psychotic illness: a 15-and 25-year international follow-up study. British Journal of Psychiatry, 178, 506517.
Harvey, P. D., Davidson, M., Mueser, K. T., et al (1997) Social-Adaptive Functioning Evaluation (SAFE): a rating scale for geriatric psychiatric patients. Schizophrenia Bulletin, 23, 131145.
Hopper, K. & Wanderling, J. (2000) Revisiting the developed versus developing country distinction in course and outcome in schizophrenia: results from ISoS, the WHO collaborative followup project. International Study of Schizophrenia. Schizophrenia Bulletin, 26, 835846.
Hutchinson, G., Bhugra, D., Mallett, R., et al (1999) Fertility and marital rates in first-onset schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 34, 617621.
Isaac, M., Kapur, R. L., Chandrasekhar, C. R., et al (1981) Management of schizophrenia patients in the community. An experimental report. Indian Journal of Psychological Medicine, 4, 2327.
Jablensky, A., Sartorius, N., Ernberg, G. et al (1992) Schizophrenia: manifestations, incidence and course in different cultures: a World Health Organization ten-country study. Psychological Medicine, Monograph Suppl., 20, 197.
Kebede, D., Alem, A., Shibre, T., et al (2005) Short-term symptomatic and functional outcomes of schizophrenia in Butajira, Ethiopia. Schizophrenia Research, 78, 171185.
Kua, J., Wong, K. E., Kua, E. H. et al (2003) A 20-year follow-up study on schizophrenia in Singapore. Acta Psychiatrica Scandinavica, 108, 118125.
Kulhara, P. & Chakrabarti, S. (2001) Culture and schizophrenia and other psychotic disorders. Psychiatric Clinics of North America, 24, 449464.
Kulhara, P. & Chandiramani, K. (1988) Outcome of schizophrenia in India using various diagnostic systems. Schizophrenia Research, 1, 339349.
Kurihara, T., Kato, M., Reverger, R., et al (2000) Outcome of schizophrenia in a non-industrialized society: comparative study between Bali and Tokyo. Acta Psychiatrica Scandinavica, 101, 148152.
Kurihara, T., Kato, M., Reverger, R., et al (2005) Eleven-year clinical outcome of schizophrenia in Bali. Acta Psychiatrica Scandinavica, 112, 456462.
Lee, P. W., Lieh-Mak, F., Wong, M. C., et al (1998) The 15-year outcome of Chinese patients with schizophrenia in Hong Kong. Canadian Journal of Psychiatry, 43, 706713.
Marwaha, S. & Johnson, S. (2004) Schizophrenia and employment. A review. Social Psychiatry and Psychiatric Epidemiology, 39, 337349.
McGlashan, T. H., Carpenter, W. T. Jr. & Bartko, J. J. (1988) Issues of design and methodology in long-term followup studies. Schizophrenia Bulletin, 14, 569574.
Mojtabai, R., Susser, E., Varma, V. K., et al (2001) Mortality and long-term course in schizophrenia with a poor 2-year course. A study in a developing country. British Journal of Psychiatry, 178, 7175.
Mueser, K. T., Salyers, M. P. & Mueser, P. R. (2001) A prospective analysis of work in schizophrenia. Schizophrenia Bulletin, 27, 281296.
Nanko, S. & Moridaria, J. (1993) Reproductive rates in schizophrenic outpatients. Acta Psychiatrica Scandinavica, 87, 400404.
Padmavathi, R., Thara, R., Srinivasan, L., et al (1995) SCARF Social Functioning Index. Indian Journal of Psychiatry, 37, 161164.
Padmavathi, R., Rajkumar, S. & Srinivasan, T. N. (1998) Schizophrenic patients who were never treated–a study in an Indian urban community. Psychological Medicine, 28, 11131117.
Pai, S. & Kapur, R. L. (1982) Impact of treatment intervention on the relationship between dimensions of clinical psychopathology, social dysfunction and burden on the family of psychiatric patients. Psychological Medicine, 12, 651658.
Patel, V., Cohen, A., Thara, R., et al (2006) Is the outcome of schizophrenia really better in developing countries? Revista Brasileira de Psiquiatria, 28, 149152.
Petersen, L., Nordentoft, M., Jeppesen, P., et al (2005) Improving 1-year outcome in first-episode psychosis: OPUS trial. British Journal of Psychiatry, 187 (suppl. 48), s98s103.
Philip, M., Gangadhar, B. N., Jagadisha, , et al (2003) Influence of duration of untreated psychosis on the short-term outcome of drug-free schizophrenia patients. Indian Journal of Psychiatry, 45, 158160.
Raguram, R., Venkateswaran, A., Ramakrishna, J., et al (2002) Traditional community resources for mental health: a report of temple healing from India. BMJ, 325, 3840.
Regier, D. A., Farmer, M. E., Rae, D. S., et al (1990) Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA, 264, 25112518.
Rosen, A., Hadzi-Pavlovic, D. & Parker, G. (1989) The Life Skills Profile: a measure assessing function and disability in schizophrenia. Schizophrenia Bulletin, 15, 325337.
Saraswat, N., Rao, K., Subbakrishna, D. K., et al (2006) The Social Occupational Functioning Scale (SOFS): a brief measure of functional status in persons with schizophrenia. Schizophrenia Research, 81, 301309.
Srinivasan, T. N. & Thara, R. (1997) How do men with schizophrenia fare at work? A follow up study from India. Schizophrenia Research, 25, 149154.
Srinivasan, T. N. & Thara, R. (2001) Beliefs about causation of schizophrenia: do Indian families believe in supernatural causes? Social Psychiatry and Psychiatric Epidemiology, 36, 134140.
Srinivasan, T. N. & Thara, R. (2002) Smoking in schizophrenia – all is not biological. Schizophrenia Research, 56, 6774
Srinivasan, L. & Tirupati, S. (2005) Relationship between cognition and work functioning among patients with schizophrenia in an urban area of India. Psychiatric Services, 56, 14231428.
Srinivasan, T. N., Rajkumar, S. & Padmavathi, R. (2001) Initiating care for untreated schizophrenia patients and results of one year follow-up. International Journal of Social Psychiatry, 47, 7380.
Susser, E. & Wanderling, J. (1994) Epidemiology of nonaffective acute remitting psychosis vs schizophrenia. Sex and sociocultural setting. Archives of General Psychiatry, 51, 294301.
Swartz, M. S., Wagner, H. R., Swanson, J. W., et al (2006) Substance use and psychosocial functioning in schizophrenia among new enrollees in the NIMH CATIE study. Psychiatric Services, 57, 11101116.
Thara, R. (2004) Twenty-year course of schizophrenia: the Madras Longitudinal Study. Canadian Journal of Psychiatry, 49, 564569.
Thara, R. & Eaton, W. W. (1996) Outcome of schizophrenia: the Madras longitudinal study. Australian and New Zealand Journal of Psychiatry, 30, 516522.
Thara, R., Henrietta, M., Joseph, A., et al (1994) Ten-year course of schizophrenia: the Madras Longitudinal Study. Acta Psychiatrica Scandinavica, 90, 329336.
Thara, R., Rajkumar, S. & Valecha, V., (1988) The Schedule for the Assessment of Psychiatric Disability. Indian Journal of Psychiatry, 30, 4753.
Thara, R., Kamath, S. & Kumar, S. (2003a) Women with schizophrenia and broken marriages – doubly disadvantaged? I. Patient perspective. International Journal of Social Psychiatry, 49, 225232.
Thara, R., Kamath, S. & Kumar, S. (2003b) Women with schizophrenia and broken marriages – doubly disadvantaged? II. Family perspective. International Journal of Social Psychiatry, 49, 233240.
Tirupati, N. S., Rangaswamy, T., Raman, P. (2004) Duration of untreated psychosis and treatment outcome in schizophrenia patients untreated for many years. Australian and New Zealand Journal of Psychiatry, 38, 339343.
Tsoi, W. F. & Wong, K. E. (1991) A 15-year follow-up study of Chinese schizophrenic patients. Acta Psychiatrcia Scandinavica, 84, 217220.
Verghese, A., Dube, K. C., John, J. K., et al (1985) Factors associated with the course and outcome of schizophrenia. Indian Journal of Psychiatry, 27, 2734.
Verghese, A., Dube, K. C., John, J. K. et al (1990) Factors associated with the course and outcome of schizophrenia. A multicentred follow-up study: result of five year follow-up. Indian Journal of Psychiatry, 32, 211216.
Wallace, C. J., Liberman, R. P., Tauber, R., et al (2000) The Independent Living Skills Survey: a comprehensive measure of the community functioning of severely and persistently mentally ill individuals. Schizophrenia Bulletin, 26, 631658.
Wiersma, D., de Jong, A. & Ormel, J. (1988) The Groningen Social Disabilities Schedule: development, relationship with I.C.I.D.H. and psychometric properties. International Journal of Rehabilitation Research, 11, 213224.
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the Present State Examination and CATEGO Program. Cambridge University Press.
World Health Organization (1979) Schizophrenia: An International Follow-Up Study. John Wiley & Sons.
World Health Organization (1998) Schedule for Clinical Assessment in Neuropsychiatry, Version 21. WHO.
World Health Organization (2000) World Health Organization Disability Assessment Schedule II (WHODAS II). WHO.
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Schizophrenia outcome measures in the wider international community

  • Mohan Isaac (a1), Prabhat Chand (a2) and Pratima Murthy (a2)
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