Asher_Current opinion review accepted version.pdf (712.79 kB)
Global mental health and schizophrenia
journal contribution
posted on 2023-06-09, 12:31 authored by Laura Asher, Abe WassieAbe Wassie, Charlotte HanlonPurpose 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.
History
Publication status
- Published
File Version
- Accepted version
Journal
Current Opinion in PsychiatryISSN
0951-7367Publisher
Lippincott, Williams & WilkinsExternal DOI
Issue
3Volume
31Page range
193-199Department affiliated with
- Global Health and Infection Publications
Research groups affiliated with
- Wellcome Trust Brighton and Sussex Centre for Global Health Research Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2018-03-20First Open Access (FOA) Date
2019-02-22First Compliant Deposit (FCD) Date
2018-03-20Usage metrics
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