Epidemiology of Untreated Psychoses in 3 Diverse Settings in the Global South: The International Research Program on Psychotic Disorders in Diverse Settings (INTREPID II).

Autor:	Morgan C; Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.; ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, King's College London, London, United Kingdom.; National Institute for Health Research Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom., Cohen A; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom., Esponda GM; Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.; ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, King's College London, London, United Kingdom., Roberts T; Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.; ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, King's College London, London, United Kingdom., John S; Schizophrenia Research Foundation, Chennai, India., Pow JL; Department of Psychiatry, University of the West Indies, Saint Augustine, Trinidad., Donald C; Department of Psychiatry, University of the West Indies, Saint Augustine, Trinidad., Olley B; Department of Psychiatry, University of Ibadan, Ibadan, Nigeria., Ayinde O; Department of Psychiatry, University of Ibadan, Ibadan, Nigeria., Lam J; Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.; ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, King's College London, London, United Kingdom., Poornachandrika P; Institute of Mental Health, Madras Medical College, Chennai, India., Dazzan P; National Institute for Health Research Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom.; Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom., Gaughran F; National Institute for Health Research Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom.; Psychosis Studies Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom., Kannan PP; Department of Psychiatry, Rajiv Gandhi General Hospital and Madras Medical College, Chennai, India., Sudhakar S; Chengelpet Medical College, Chengelpet, Tamil Nadu, India., Burns J; Mental Health Research Group, College of Medicine and Health, University of Exeter, Exeter, United Kingdom., Chiliza B; Department of Psychiatry, University of KwaZulu Natal, Durban, South Africa., Susser E; Columbia Mailman School of Public Health, Columbia University, New York, New York.; New York Psychiatric Institute, New York., Weiss HA; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom., Murray RM; National Institute for Health Research Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom.; Psychosis Studies Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom., Rangaswamy T; Schizophrenia Research Foundation, Chennai, India., Gureje O; Department of Psychiatry, University of Ibadan, Ibadan, Nigeria., Hutchinson G; Department of Psychiatry, University of the West Indies, Saint Augustine, Trinidad., Agboola A; Department of Psychiatry, University of Ibadan, Ibadan, Nigeria., Fadahunsi O; Department of Psychiatry, University of Ibadan, Ibadan, Nigeria., Idowu O; Department of Psychiatry, University of Ibadan, Ibadan, Nigeria., Obuene C; Department of Psychiatry, University of Ibadan, Ibadan, Nigeria., Ojagbemi A; Department of Psychiatry, University of Ibadan, Ibadan, Nigeria., Olayiwola B; Department of Psychiatry, University of Ibadan, Ibadan, Nigeria., Owoeye S; Department of Psychiatry, University of Ibadan, Ibadan, Nigeria., Amaldoss K; Schizophrenia Research Foundation, Chennai, India., Aynkaran JR; Schizophrenia Research Foundation, Chennai, India., Balashanmugam A; Schizophrenia Research Foundation, Chennai, India., Chockalingam P; Schizophrenia Research Foundation, Chennai, India., Devanathan K; Schizophrenia Research Foundation, Chennai, India., Gopal S; Schizophrenia Research Foundation, Chennai, India., Kumar R; Schizophrenia Research Foundation, Chennai, India., Ramachandran P; Schizophrenia Research Foundation, Chennai, India., Samikannu K; Schizophrenia Research Foundation, Chennai, India., Bharath-Khan D; Department of Psychiatry, University of the West Indies, Saint Augustine, Trinidad., Jadoo D; Department of Psychiatry, University of the West Indies, Saint Augustine, Trinidad., Marcellin E; Department of Psychiatry, University of the West Indies, Saint Augustine, Trinidad., Raymond E; Department of Psychiatry, University of the West Indies, Saint Augustine, Trinidad., Sooknanan G; Department of Psychiatry, University of the West Indies, Saint Augustine, Trinidad., Subnaik L; Department of Psychiatry, University of the West Indies, Saint Augustine, Trinidad., Williams D; Department of Psychiatry, University of the West Indies, Saint Augustine, Trinidad.
Jazyk:	angličtina
Zdroj:	JAMA psychiatry [JAMA Psychiatry] 2023 Jan 01; Vol. 80 (1), pp. 40-48.
DOI:	10.1001/jamapsychiatry.2022.3781
Abstrakt:	Importance: Less than 10% of research on psychotic disorders has been conducted in settings in the Global South, which refers broadly to the regions of Latin America, Asia, Africa, and Oceania. There is a lack of basic epidemiological data on the distribution of and risks for psychoses that can inform the development of services in many parts of the world. Objective: To compare demographic and clinical profiles of cohorts of cases and rates of untreated psychoses (proxy for incidence) across and within 3 economically and socially diverse settings in the Global South. Two hypotheses were tested: (1) demographic and clinical profiles of cases with an untreated psychotic disorder vary across setting and (2) rates of untreated psychotic disorders vary across and within setting by clinical and demographic group. Design, Setting, and Participants: The International Research Program on Psychotic Disorders in Diverse Settings (INTREPID II) comprises incidence, case-control, and cohort studies of untreated psychoses in catchment areas in 3 countries in the Global South: Kancheepuram District, India; Ibadan, Nigeria; and northern Trinidad. Participants were individuals with an untreated psychotic disorder. This incidence study was conducted from May 1, 2018, to July 31, 2020. In each setting, comprehensive systems were implemented to identify and assess all individuals with an untreated psychosis during a 2-year period. Data were analyzed from January 1 to May 1, 2022. Main Outcomes and Measures: The presence of an untreated psychotic disorder, assessed using the Schedules for Clinical Assessment in Neuropsychiatry, which incorporate the Present State Examination. Results: Identified were a total of 1038 cases, including 64 through leakage studies (Kancheepuram: 268; median [IQR] age, 42 [33-50] years; 154 women [57.5%]; 114 men [42.5%]; Ibadan: 196; median [IQR] age, 34 [26-41] years; 93 women [47.4%]; 103 men [52.6%]; Trinidad: 574; median [IQR] age, 30 [23-40] years; 235 women [40.9%]; 339 men [59.1%]). Marked variations were found across and within settings in the sex, age, and clinical profiles of cases (eg, lower percentage of men, older age at onset, longer duration of psychosis, and lower percentage of affective psychosis in Kancheepuram compared with Ibadan and Trinidad) and in rates of untreated psychosis. Age- and sex-standardized rates of untreated psychoses were approximately 3 times higher in Trinidad (59.1/100 000 person-years; 95% CI, 54.2-64.0) compared with Kancheepuram (20.7/100 000 person-years; 95% CI, 18.2-23.2) and Ibadan (14.4/100 000 person-years; 95% CI, 12.3-16.5). In Trinidad, rates were approximately 2 times higher in the African Trinidadian population (85.4/100 000 person-years; 95% CI, 76.0-94.9) compared with the Indian Trinidadian (43.9/100 000 person-years; 95% CI, 35.7-52.2) and mixed populations (50.7/100 000 person-years; 95% CI, 42.0-59.5). Conclusions and Relevance: This analysis adds to research that suggests that core aspects of psychosis vary by historic, economic, and social context, with far-reaching implications for understanding and treatment of psychoses globally.
Databáze:	MEDLINE
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