Global mental health and schizophrenia

PURPOSE OF REVIEW: The aim was to synthesize recent evidence on schizophrenia illness experience and outcomes and models of care in low and middle-income countries (LMICs). RECENT FINDINGS: There is a plurality of explanatory models for psychosis and increasing evidence that context influences e...

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Main Authors: Asher, Laura, Fekadu, Abebaw, Hanlon, Charlotte
Format: Article
Published: Lippincott Williams & Wilkins 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/50972/
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author Asher, Laura
Fekadu, Abebaw
Hanlon, Charlotte
author_facet Asher, Laura
Fekadu, Abebaw
Hanlon, Charlotte
author_sort Asher, Laura
building Nottingham Research Data Repository
collection Online Access
description PURPOSE OF REVIEW: The aim was to synthesize recent evidence on schizophrenia illness experience and outcomes and models of care in low and middle-income countries (LMICs). RECENT FINDINGS: There is a plurality of explanatory models for psychosis and increasing evidence that context influences experiences of stigma. People with schizophrenia in LMICs are vulnerable to food insecurity, violence and physical health problems, in addition to unmet needs for mental healthcare. Family support may help to improve outcomes if present, but caregivers may be overwhelmed by the challenges faced. Despite efforts to increase availability, evidence-based care remains inaccessible to many people with schizophrenia. Non-randomized evaluations in South Africa and Mexico indicate that psychosocial support groups for people with schizophrenia and caregivers may be acceptable and useful. Randomized controlled trials in Pakistan and China show that culturally adapted cognitive-behavioural therapy can reduce symptom severity. There is emerging evidence that alternative medicine, such as Tai Chi, may be beneficial, but to date most studies are of low quality. The challenges of biomedical-traditional provider collaborations have been highlighted. Evaluations of integrated mental healthcare in primary care are underway and promise to provide vital information about how to scale-up quality care. SUMMARY: Acceptable and effective responses to schizophrenia in LMICs should be cognisant of both cultural context and universal concerns. Efforts to enhance the quality of family support should be central to models of care.
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spelling nottingham-509722020-05-04T19:35:08Z https://eprints.nottingham.ac.uk/50972/ Global mental health and schizophrenia Asher, Laura Fekadu, Abebaw Hanlon, Charlotte PURPOSE OF REVIEW: The aim was to synthesize recent evidence on schizophrenia illness experience and outcomes and models of care in low and middle-income countries (LMICs). RECENT FINDINGS: There is a plurality of explanatory models for psychosis and increasing evidence that context influences experiences of stigma. People with schizophrenia in LMICs are vulnerable to food insecurity, violence and physical health problems, in addition to unmet needs for mental healthcare. Family support may help to improve outcomes if present, but caregivers may be overwhelmed by the challenges faced. Despite efforts to increase availability, evidence-based care remains inaccessible to many people with schizophrenia. Non-randomized evaluations in South Africa and Mexico indicate that psychosocial support groups for people with schizophrenia and caregivers may be acceptable and useful. Randomized controlled trials in Pakistan and China show that culturally adapted cognitive-behavioural therapy can reduce symptom severity. There is emerging evidence that alternative medicine, such as Tai Chi, may be beneficial, but to date most studies are of low quality. The challenges of biomedical-traditional provider collaborations have been highlighted. Evaluations of integrated mental healthcare in primary care are underway and promise to provide vital information about how to scale-up quality care. SUMMARY: Acceptable and effective responses to schizophrenia in LMICs should be cognisant of both cultural context and universal concerns. Efforts to enhance the quality of family support should be central to models of care. Lippincott Williams & Wilkins 2018-05-01 Article PeerReviewed Asher, Laura, Fekadu, Abebaw and Hanlon, Charlotte (2018) Global mental health and schizophrenia. Current Opinion in Psychiatry, 31 (3). pp. 193-199. ISSN 1473-6578 Schizophrenia low and middle-income countries global mental health mental health Gap Action Programme https://journals.lww.com/co-psychiatry/Abstract/2018/05000/Global_mental_health_and_schizophrenia.6.aspx doi:10.1097/yco.0000000000000404 doi:10.1097/yco.0000000000000404
spellingShingle Schizophrenia
low and middle-income countries
global mental health
mental health Gap Action Programme
Asher, Laura
Fekadu, Abebaw
Hanlon, Charlotte
Global mental health and schizophrenia
title Global mental health and schizophrenia
title_full Global mental health and schizophrenia
title_fullStr Global mental health and schizophrenia
title_full_unstemmed Global mental health and schizophrenia
title_short Global mental health and schizophrenia
title_sort global mental health and schizophrenia
topic Schizophrenia
low and middle-income countries
global mental health
mental health Gap Action Programme
url https://eprints.nottingham.ac.uk/50972/
https://eprints.nottingham.ac.uk/50972/
https://eprints.nottingham.ac.uk/50972/