Antipsychotic treatment, psychoeducation & regular follow up as a public health strategy for schizophrenia: Results from a prospective study
| Autor: | Jagadisha Thirthalli, Basappa K. Venkatesh, K.K. Suresha, Channaveerachari Naveen Kumar, Bangalore N. Gangadhar, Udupi Arunachala |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
rural community medicine.medical_treatment Psychological intervention lcsh:Medicine General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine medicine Psychoeducation Antipsychotics Humans 030212 general & internal medicine Psychiatry Prospective cohort study Primary Health Care Positive and Negative Syndrome Scale business.industry lcsh:R General Medicine medicine.disease 030227 psychiatry schizophrenia disability Schizophrenia Antipsychotics - course - disability - outcome - rural community - schizophrenia Cohort outcome Original Article business Psychosocial course Psychopathology |
| Zdroj: | Indian Journal of Medical Research, Vol 146, Iss 1, Pp 34-41 (2017) The Indian Journal of Medical Research |
| ISSN: | 0971-5916 |
| DOI: | 10.4103/ijmr.ijmr_838_15 |
| Popis: | Background & objectives: In low- and middle-income countries such as India, a feasible public health strategy could be to ensure continuous antipsychotics and psychoeducation for those with schizophrenia. Whether such a strategy favourably influences its course and outcome is not well-studied. The objectives of this study were to examine these issues in a cohort of patients with schizophrenia in a rural south Indian taluk (an administrative block). This cohort was part of a community intervention programme running in the place since the past one decade. Methods: A total of 201 patients were assessed after an average of four years of follow up. Psychopathology, disability and course of illness were assessed using Positive and Negative Syndrome Scale (PANSS), Indian Disability Evaluation and Assessment Scale (IDEAS) and Psychiatric and Personal History Schedule (PPHS), respectively. Interventions included ensuring continuous antipsychotic treatment and low-intensity psychoeducation. Results: One hundred and forty two [70.6%; 95% confidence interval (CI): 64.35-76.95] of the 201 patients achieved clinical remission by the end of follow up period (four years); 140 (69.6%; 95% CI: 63.29-76.07) had satisfactory outcome (42.3% best outcome and 27.4% intermediate outcome). There was a significant reduction in the proportion of patients with disability [134/201 (66.7%) at baseline; 55/201 (27.3%) at follow up; P< 0.01]. Best course pattern and least disability were seen in patients with best treatment adherence. Interpretation & conclusions: Treatment with antipsychotics and psychoeducation can favourably influence the course of schizophrenia and reduce disability in a substantial proportion of patients. Structured psychosocial interventions may be indicated in the significant minority who show suboptimal outcome with this strategy. |
| Databáze: | OpenAIRE |
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