Questioning an axiom: Better prognosis for schizophrenia in the developing world?


Cohen, A; Patel, V; Thara, R; Gureje, O; (2008) Questioning an axiom: Better prognosis for schizophrenia in the developing world? Schizophrenia bulletin, 34 (2). pp. 229-244. ISSN 0586-7614 DOI: https://doi.org/10.1093/schbul/sbm105

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Abstract

Introduction: That schizophrenia has a better course and outcome in developing countries has become an axiom in international psychiatry. This is based primarily on a series of cross-national studies by the World Health Organization (WHO). However, increasing evidence from other research indicates a far more complex picture. Methods: Literature review and tabulation of data from 23 longitudinal studies of schizophrenia outcomes in 11 low- and middle-income countries. Results: We reviewed the evidence about the following domains: clinical outcomes and patterns of course, disability and social outcomes (marital and occupational status, in particular), and untreated samples and duration of untreated psychosis. Outcomes varied across the studies and the evidence suggests a need to reexamine the conclusions of the WHO studies. Additionally, assessments of outcomes should take excess mortality and suicide into account. Conclusions: It is time to reexamine presumed wisdom about schizophrenia outcomes in low- and middle-income countries.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 17905787
Web of Science ID: 253859400006
URI: http://researchonline.lshtm.ac.uk/id/eprint/7974

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