Early intervention for psychosis services in low and middle income countries
Keywords:
early intervention, LMIC, low and middle income countries, psychosis, schizophreniaAbstract
Objective To conduct a systematic review of the early intervention services for psychosis available in low-and middle-income countries. The results would help to improve the mental health service in Thailand.
Material and methods A systematic review of Pubmed, Psychinfo, Medline, and Embase of all available literature in English up to 2016 using specific search terms. Data was extracted from the included studies.
Results Three low and middle income countries, i.e. India, Kenya and Pakistan have some forms of early intervention services for psychosis. All were community-based using mixed methods by trained health professionals. People with psychosis who were included in these programmes were observed to have better outcomes than people who were not.
Conclusion Although only a few low and middle income countries offer early intervention services for psychosis, those that do provide them have demonstrated satisfying outcomes even with limited resources and personnel. This means similar service would be feasible for Thailand to enable
a better care for people with early psychosis.
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References
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38. Chan SK, Chau EH, Hui CL, Chang WC, Lee EH, Chen EY. Long term effect of early intervention service on duration of untreated psychosis in youth and adult population in Hong Kong. Early Interv Psychiatry
2018;12:331-8.
39. Soongkhang I, Prukkanone B. Effectiveness of the mental health gap action program in Thailand. Journal of Health Science 2014;23: 427-36. (in Thai)
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41. McCrone P, Craig TK, Power P, Garety PA. Costeffectiveness of an early intervention service for people with psychosis. Br J Psychiatry 2010;196:377-82.
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2. Jaaskelainen E, Juola P, Hirvonen N, McGrath JJ, Saha S, Isohanni M, et al. A systematic review and metaanalysis of recovery in schizophrenia. Schizophr Bull 2013;39:1296-306.
3. Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T. The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010. PloS one 2015;10.
4. World Health Organization. The global burden of disease: 2004 update. Geneva, Switzerland: World Health Organization; 2008.
5. Phanthunane P, Vos T, Whiteford H, Bertram M, Udomratn P. Schizophrenia in Thailand: prevalence and burden of disease. Popul Health Metr 2010;8:24.
6. Leucht S, Cipriani A, Spineli L, Mavridis D, Örey D, Richter F, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multipletreatments meta-analysis. Lancet 2013;382:951-62.
7. Wils RS, Gotfredsen DR, Hjorthøj C, Austin SF, Albert N, Secher RG, et al. Antipsychotic medication and remission of psychotic symptoms 10 years after a first-episode psychosis. Schizophr Res 2016;182:42-8.
8. Edwards J, Harris MG, Bapat S. Developing services for first-episode psychosis and the critical period. Br J Psychiatry 2005;187 (suppl 48):s91-7.
9. Kreyenbuhl J, Buchanan RW, Dickerson FB, Dixon LB. The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2009. Schizophr Bull 2010;36:94-103.
10. Kelleher I, Harley M, Murtagh A, Cannon M. Are Screening instruments valid for psychotic-like experiences? a validation study of screening questions for psychotic-like experiences using in-depth clinical interview. Schizophr Bull 2011;37:362-9.
11. Capra C, Kavanagh DJ, Hides L, Scott J. Brief screening for psychosis-like experiences. Schizophr Res 2013;149:104-7.
12. Kline E, Schiffman J. Psychosis risk screening: a systematic review. Schizophr Res 2014; 158:11.
13. Savill M, D’Ambrosio J, Cannon TD, Loewy RL. Psychosis risk screening in different populations using the Prodromal Questionnaire: a systematic review. Early Interv Psychiatry
2018;12:3-14.
14. Kittirattanapaiboon P, Tantirangsee N, Chuta W, Assanangkornchai S, Supanya S. Thai National Mental Health Survey 2013: Methodology and Procedure. Journal of Mental Health of Thailand 2016;24:1-14. (in Thai)
15. Supanya S, The Thai National Mental Health Survey Working Group, Morgan C, Reininghaus U, editors. Prevalence, type and frequency of psychotic experiences in Thailand: results from the 2013 Thai national mental health survey (C4). IEPA 10th International Conference of Early Intervention in Mental Health – “Looking Back, Moving Forward” Milan, Italy, 20th-22nd October 2016. Early Interv Psychiatry 2016; 10 suppl 1:198.
16. Üçok A, Polat A, Genç A, Çakιr S, Turan N. Duration of untreated psychosis may predict acute treatment response in first-episode schizophrenia. J Psychiatr Res 2004;38:163-8.
17. Marshall M, Lewis S, Lockwood A, Drake R, Jones P, Croudace T. Association between duration of untreated psychosis and outcome in cohorts of first-episode patients. Arch Gen Psychiatry. 2005;62:975-83.
18. Drake RJ. Causes and consequences of duration of untreated psychosis in schizophrenia. Br J Psychiatry 2000;177:511-5.
19. Ito S, Nemoto T, Tsujino N, Ohmuro N, Matsumoto K, Matsuoka H, et al. Differential impacts of duration of untreated psychosis (DUP) on cognitive function in first-episode schizophrenia according to mode of onset. Eur Psychiatry 2015;30:995-1001.
20. Marshall M, Rathbone J. Early intervention for psychosis. Cochrane Database Syst Rev. 2011(6):CD004718.
21. McGorry P. Innovations in the design of mental health services for young people: an Australian perspective. Innovation and Entrepreneurship in Health 2015:2:107-113.
22. Corsico P, Griffin-Doyle M, Singh I. What constitutes ‘good practice’ in early intervention for psychosis? analysis of clinical guidelines. Child and Adolescent Mental Health 2017. doi:10.1111/camh.12229.
23. Randall JR, Vokey S, Loewen H, Martens PJ, Brownell M, Katz A, et al. A systematic review of the effect of early interventions for psychosis on the usage of inpatient services. Schizophr Bull 2015;41:1379-86.
24. Marwaha S, Thompson A, Upthegrove R, Broome MR. Fifteen years on early intervention for a new generation. Br J Psychiatry 2016;209:186-8.
25. Randall JR, Chateau D, Smith M, Taylor C, Bolton J, Katz L, et al. An early intervention for psychosis and its effect on criminal accusations and suicidal behaviour using a matched-cohort design. Schizophr Res 2016;176:307-11.
26. Chesney E, Abdin E, Poon LY, Subramaniam M, Verma S. Pathways to care for patients with first-episode psychosis in Singapore. J Nerv Ment Dis 2016;204:291-7.
27. Chang WC, Kwong VW, Lau ES, So HC, Wong CS, Chan GH, et al. Sustainability of treatment effect of a 3-year early intervention programme for first-episode psychosis. Br J Psychiatry 2017;211:37-44.
28. Supanya S, Kwansanit P. Systematic review of the early intervention services for first-episode psychosis in low-and middle-income countries. PROSPERO 2016 CRD42016029232.
2016.
29. World Bank country and lending group [Internet]. Washington, DC:The World Bank; 2014. Available from: http://data.worldbank.org/about/country-and-lending-groups.
30. Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic
reviews. BMC medical research methodology. 2007;7:10.
31. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009;62:1006-12.
32. Chatterjee S, Pillai A, Jain S, Cohen A, Patel V. Outcomes of people with psychotic disorders in a community-based rehabilitation programme in rural India. Br J Psychiatry 2009;195:433-9.
33. Chatterjee S, Naik S, John S, Dabholkar H, Balaji M, Koschorke M, et al. Effectiveness of a community-based intervention for people with schizophrenia and their caregivers in India (COPSI): a randomised controlled trial. Lancet 2014;383:1385-94.
34. Naeem F, Habib N, Gul M, Khalid M, Saeed S, Farooq S, et al. A qualitative study to explore patients’, carers’ and health professionals’ views to culturally adapt CBT for psychosis (CBTp) in Pakistan. Behav Cogn Psychother 2016;44:43-55.
35. de Menil V, Knapp M, McDaid D, Raja S, Kingori J, Waruguru M, et al. Cost-effectiveness of the Mental Health and Development model for schizophrenia-spectrum and bipolar disorders in rural Kenya. Psychol Med 2015;45:2747-56.
36. Bureau of Mental Health Service Administration, The mhGAP implementation program for psychosis: field guide manual. Nonthaburi: Department of Mental Health, Ministry of Public Health; 2014. (in Thai)
37. Bird V, Premkumar P, Kendall T, Whittington C, Mitchell J, Kuipers E. Early intervention services, cognitivebehavioural therapy and family intervention in early psychosis: systematic review. Br J Psychiatry 2010;197:350-6.
38. Chan SK, Chau EH, Hui CL, Chang WC, Lee EH, Chen EY. Long term effect of early intervention service on duration of untreated psychosis in youth and adult population in Hong Kong. Early Interv Psychiatry
2018;12:331-8.
39. Soongkhang I, Prukkanone B. Effectiveness of the mental health gap action program in Thailand. Journal of Health Science 2014;23: 427-36. (in Thai)
40. Allard J, Lancaster S, Clayton S, Amos T, Birchwood M. Carers’ and service users’ experiences of early intervention in psychosis services: implications for care partnerships. Early Interv Psychiatry 2018;12:410-6.
41. McCrone P, Craig TK, Power P, Garety PA. Costeffectiveness of an early intervention service for people with psychosis. Br J Psychiatry 2010;196:377-82.
42. Aydin C, Tibbo PG, Ursuliak Z. Psychosocial interventions in reducing cannabis use in early phase psychosis: a Canadian survey of treatments offered. Can J Psychiatry 2016;61:367-72.
43. WHO. Thailand [Internet]. Geneva: World Health Organization; 2011. Available from: http://www.who.int/countries/tha/en/.
44. WHO. Mental health atlas 2011 [Internet]. Geneva: World Health Organization; 2011. Available from: http://www.who.int/iris/handle/10665/44697.
45. Suraaroonsamrit B, Panyayong B. The development of mental health and psychiatric service in health areas. Journal of Mental Health of Thailand 2014;22:142-56. (in Thai)
46. World Health Organization. Mental health global action programme: scaling up care for mental, neurological and substance use disorders. Geneva: World Health Organization; 2008.
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Published
2018-05-31
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Supanya S, Kwansanit P. Early intervention for psychosis services in low and middle income countries. J Ment Health Thai [internet]. 2018 May 31 [cited 2026 Jan. 1];26(2):142-51. available from: https://he01.tci-thaijo.org/index.php/jmht/article/view/146776
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