Community outreach for untreated schizophrenia in rural India: a follow-up study of symptoms, disability, family burden and costs.
| Autor: | Srinivasa Murthy R; Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India., Kishore Kumar KV, Chisholm D, Thomas T, Sekar K, Chandrashekari CR |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Psychological medicine [Psychol Med] 2005 Mar; Vol. 35 (3), pp. 341-51. |
| DOI: | 10.1017/s0033291704003551 |
| Abstrakt: | Background: In resource-poor countries, there remains an alarming treatment gap for people with schizophrenia, particularly those living in rural areas. Decentralization of mental health services, including community-based outreach programmes, represents one obvious strategy for bringing appropriate care to these communities. This study set out to assess the costs and effects of such a programme in rural Karnataka in India. Method: Eight rural communities were visited by an outreach team, who identified cases of drug-naive or currently untreated schizophrenia. Recruited cases were provided with appropriate psychotropic medication and psychosocial support, and after obtaining informed consent were assessed every 3 months over one and a half years on symptomatology, disability, family burden, resource use and costs. A repeated-measures analysis was carried out to test for significant change in these outcome measures over this period. Results: A total of 100 cases of untreated schizophrenia were recruited, of whom 28% had never received antipsychotic medication and the remaining 72% had not been on medication for the past 6 months. Summary scores for psychotic symptoms, disability and family burden were all reduced significantly, with particular improvement observed at the first follow-up assessment. Increases in treatment and community outreach costs over the follow-up period were accompanied by reductions in the costs of informal-care sector visits and family care-giving time. Conclusions: Efforts to organize community-based care such as outreach services for people with schizophrenia living in more remote areas of resource-constrained countries can bring substantial benefits to patients and families alike. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|