1
|
Stockner M, Wenter A, Obexer A, Gualtieri I, Merler F, Bennato D, Conca A. Emotional reactions and stigmatization after a parricide in South Tyrol, Italy, among mental health professionals and the general population, including persons with mental disorders, relatives, and persons with no direct or indirect contact. Front Public Health 2024; 12:1388842. [PMID: 39011331 PMCID: PMC11247646 DOI: 10.3389/fpubh.2024.1388842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/11/2024] [Indexed: 07/17/2024] Open
Abstract
Introduction This study was conducted on the occasion of the parricide in Bolzano (South Tyrol, Italy) in January 2021. The psychological impact of parricide on the general population and on mental health professionals has scarcely been investigated to the present day. Studies on stigmatization show differences between various groups. The aim was to analyze the emotional reactions to the parricide and the stigmatization of persons with mental disorders in the South Tyrolian population. Methods In September 2022, 121 mental health professionals of the Department of Psychiatry in Bolzano were surveyed using an online questionnaire. In addition, from January to March 2023, the general population of South Tyrol was invited to take part in the survey through an online-link and was divided into three groups: 267 persons with mental health problems, 855 relatives and 1,019 persons with no direct or indirect contact to people with mental problems. The validated Reported and Intended Behavior Scale (RIBS) was used together with questions on the emotional reactions to the parricide and the perceived dangerousness of psychiatric patients. Descriptive statistics, one-way Anovas as well as regressions were carried out. Results and discussion All groups experienced sadness the most. Relatives experienced more sadness and anger than the other groups. Over 80% of the professionals stated that psychiatric patients were not at greater risk of committing parricide. The population with no contact rated the risk higher than those affected and had the lowest level of openness (RIBS). There were no differences between genders, but there were age differences, with younger people being more stigmatizing. The results suggest that personal contact, appropriate information, and education are associated with less stigmatization.
Collapse
Affiliation(s)
- Mara Stockner
- Department of Dynamic and Clinical Psychology, Faculty of Psychology, Sapienza University of Rome, Rome, Italy
| | - Anna Wenter
- Department of Psychology, Institute of Psychology and Sports, University of Innsbruck, Innsbruck, Austria
| | - Artur Obexer
- Department of Psychiatry, Health District of Bolzano (SABES-ASDAA), Bolzano, Italy
| | - Isabella Gualtieri
- Department of Psychiatry, Health District of Bolzano (SABES-ASDAA), Bolzano, Italy
| | - Francesca Merler
- Department of Psychiatry, Health District of Bolzano (SABES-ASDAA), Bolzano, Italy
| | - Davide Bennato
- Department of Humanities, University of Catania, Catania, Italy
| | - Andreas Conca
- Department of Psychiatry, Health District of Bolzano (SABES-ASDAA), Bolzano, Italy
| |
Collapse
|
2
|
Corrao G, Monzio Compagnoni M, Conflitti C, Lora A. Is the long-term poor prognosis of acute myocardial infarction in patients with mental illness mediated through their poor adherence with recommended healthcare? Eur J Public Health 2024; 34:584-591. [PMID: 38268304 PMCID: PMC11161155 DOI: 10.1093/eurpub/ckae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Compared with patients without evidence of psychiatric symptoms, those with mental disorders experience reduced adherence with recommended healthcare and poorer clinical outcomes. This study aimed to evaluate whether the worse prognosis of patients with mental disorders after experiencing acute myocardial infarction could be fully or partially mediated by their reduced adherence to recommended healthcare. METHODS In this retrospective cohort population-based study, 103 389 residents in the Italian Lombardy Region who experienced acute myocardial infarction in 2007-19 were identified. Among them, 1549 patients with severe mental illness (SMI) were matched with five cohort members without evidence of mental disorders (references). Recommended healthcare (cardiac medicaments and selected outpatient services) was evaluated in the year after the date of index hospital discharge. The first occurrences of cardiovascular (CV) hospital admissions and any-cause-death were considered as endpoints. Mediation analysis was performed to investigate whether post-discharge use of recommended healthcare may be considered a mediator of the relationship between healthcare exposure and endpoints occurrence. RESULTS Compared with references, patients with SMI had lower adherence with recommended healthcare and adjusted risk excesses of 39% and 73% for CV hospitalizations and all-cause mortality. Mediation analysis showed that 4.1% and 11.3% of, respectively, CV hospitalizations and deaths occurred among psychiatric patients was mediated by their worse adherence to specific healthcare. CONCLUSION The reduced use of recommended outpatient healthcare by patients with SMI had only a marginal effect on their worse prognosis. Other key factors mediating the prognostic gap between patients with and without mental disorders should be investigated.
Collapse
Affiliation(s)
- Giovanni Corrao
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Matteo Monzio Compagnoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Claudia Conflitti
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- Department of Mental Health and Addiction Services, ASST Lecco, Lecco, Italy
| | - Antonio Lora
- National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- Department of Mental Health and Addiction Services, ASST Lecco, Lecco, Italy
| |
Collapse
|
3
|
Causier C, Johns L, Radez J, Hassan H, Maughan D, Waite F. Experiences of Help-Seeking for Severe Mental Health Problems in Young Pakistani Women: A Preliminary Qualitative Study. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2024; 55:429-443. [PMID: 38766627 PMCID: PMC11101305 DOI: 10.1177/00220221241236944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Almost three quarters of mental illnesses start by the age of 25, yet youth (18-25-year-olds) are often underrepresented in U.K. services. This is particularly true for those of ethnic minorities. In this study, we aimed to understand how young Pakistani women and their parents make decisions to seek help for severe mental health problems, and the barriers and facilitators to accessing professional help. Young Pakistani women with experience of severe mental health problems and their parents were recruited from a community sample. Semi-structured interviews were conducted with six young people and two parents. Data were analyzed using reflexive thematic analysis. Pakistani culture and its interplay with British culture strongly influenced the decisions and ability of young Pakistani women and their parents to help-seek, largely through the role of stigma. Low mental health literacy, stigma, and a lack of culturally informed services were identified as the most common barriers to accessing care. These barriers fed into the internalized stigma these young women experienced which, through fear of damaged reputation and personal prejudices, posed further barriers to seeking help. Participants highlighted recommendations for both individual-level (e.g., increased education and awareness) and service-level (e.g., greater choice over care) change to facilitate accessibility of professional help. Young Pakistani women face multiple culturally related challenges to accessing care for severe mental health problems at both the individual- and service-level. Novel suggestions to address these challenges, such as including youth peer support workers in services, may facilitate more inclusive and accessible services.
Collapse
Affiliation(s)
- Chiara Causier
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | - Louise Johns
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | - Jerica Radez
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | - Hibah Hassan
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | | | - Felicity Waite
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| |
Collapse
|
4
|
Faruk MO, Khan AH, Chowdhury KUA, Jahan S, Sarker DC, Colucci E, Hasan MT. Mental illness stigma in Bangladesh: Findings from a cross-sectional survey. Glob Ment Health (Camb) 2023; 10:e59. [PMID: 37854431 PMCID: PMC10579681 DOI: 10.1017/gmh.2023.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/12/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023] Open
Abstract
Background Mental illness stigma is universally prevalent and a significant barrier to achieving global mental health goals. Mental illness stigma in Bangladesh has gained little attention despite its widespread impact on seeking mental health care in rural and urban areas. This study aimed to investigate mental illness stigma and the associated factors in rural and urban areas of Bangladesh. Methods The study areas were divided into several clusters from which 325 participants (≥18 years) were recruited with systematic random sampling. The Bangla version of the Days' Mental Illness Stigma Scale was used to collect data. Independent-samples t-test, ANOVA, and multiple regression were performed. Results Results suggest that gender, age, geographical location, socioeconomic status, and occupation significantly differed across subscales of stigma. Age, gender, seeking treatment of mental illness, having knowledge on mental health, and socioeconomic status were predictive factors of mental illness stigma. The results also showed a high treatment gap in both rural and urban areas. Conclusion This study supports that mental illness stigma is prevalent in Bangladesh, requiring coordinated efforts. Results can inform the development of contextually tailored mental health strategies to reduce stigma and contribute to the promotion of mental health of individuals and communities across Bangladesh.
Collapse
Affiliation(s)
- Md Omar Faruk
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Abid Hasan Khan
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Kamal Uddin Ahmed Chowdhury
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
- Nasirullah Psychotherapy Unit, Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Sabiha Jahan
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Depon Chandra Sarker
- Child Development Center, Department of Pediatrics, Satkhira Medical College and Hospital, Satkhira, Bangladesh
| | | | - M. Tasdik Hasan
- Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, VIC, Australia
- Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh
| |
Collapse
|
5
|
Hedemann TL, Asif M, Aslam H, Maqsood A, Bukhsh A, Kiran T, Ahsan U, Shahzad S, Zaheer J, Lane S, Chaudhry N, Husain MI, Husain MO. Clinicians', patients' and carers' perspectives on borderline personality disorder in Pakistan: A mixed methods study protocol. PLoS One 2023; 18:e0286459. [PMID: 37267274 DOI: 10.1371/journal.pone.0286459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 05/12/2023] [Indexed: 06/04/2023] Open
Abstract
Borderline Personality Disorder (BPD) is a condition characterised by significant social and occupational impairment and high rates of suicide. In high income countries, mental health professionals carry negative attitudes towards patients with BPD, find it difficult to work with patients with BPD, and even avoid seeing these patients. Negative attitudes and stigma can cause patients to fear mistreatment by health care providers and create additional barriers to care. Patients' self-stigma and illness understanding BPD also affects treatment engagement and outcomes; better knowledge about mental illness predicts intentions to seek care. The perspectives of mental health clinicians and patients on BPD have not been researched in the Pakistani setting and likely differ from other settings due to economic, cultural, and health care system differences. Our study aims to understand the attitudes of mental health clinicians towards patients with BPD in Pakistan using a self-report survey. We also aim to explore explanatory models of illness in individuals with BPD and their family members/carers using a Short Explanatory Model Interview (SEMI). The results of this study are important as we know attitudes and illness understanding greatly impact care. Results of this study will help guide BPD-specific training for mental health clinicians who care for patients with BPD and help inform approaches to interventions for patients with BPD in Pakistan.
Collapse
Affiliation(s)
| | - Muqaddas Asif
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Huma Aslam
- Department of Psychiatry and Behavioral Sciences, Allama Iqbal Medical College and Jinnah Hospital, Lahore, Pakistan
| | | | - Ameer Bukhsh
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Tayyeba Kiran
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Umair Ahsan
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Salman Shahzad
- Institute of Clinical Psychology, University of Karachi, Karachi, Pakistan
| | - Juveria Zaheer
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | - Steven Lane
- University of Liverpool, Liverpool, United Kingdom
| | - Nasim Chaudhry
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - M Ishrat Husain
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | - M Omair Husain
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| |
Collapse
|
6
|
Mitelman M, Chirazi A, Schmollgruber A, Leiderman EA. Discrimination and social stigma against people with mental illnesses in Argentina. Int J Soc Psychiatry 2023; 69:334-341. [PMID: 35422147 DOI: 10.1177/00207640221089533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Individuals with mental and neurological illnesses face stigma and discrimination every day. There are only a few studies regarding the degree of discrimination in the comparison between the illnesses, and no recent research has been found in Argentina about this topic. AIMS The aim of this research is to study and compare stigma and discrimination toward people with mental illnesses (schizophrenia, substance use disorder, and bipolar disorder) and with neurological disorders (epilepsy) in Argentina, while analyzing the social distance toward them. The level of responsibility attributed to individuals with these disorders were also assessed and compared. METHOD Individuals from Buenos Aires, Argentina, were surveyed in order to measure the social distance given to people with mental illnesses and a neurological disease. For that purpose a modified version of the Bogardus scale was used, with a sample of 500 individuals contacted online in January 2021. RESULTS Social distance toward people with mental illnesses was higher than those with a neurological disorder (epilepsy). A significant difference was found in the level of responsibility attributed to people with substance use disorder in comparison to the other illnesses. On the contrary, there were no significant differences of discrimination according to age or sex. Finally, the research outcomes showed that people with substance use disorder are the most discriminated against and stigmatized. CONCLUSION A significant level of discrimination was found against individuals with mental disorders and, specially, toward people with substance use disorder. Moreover, they are perceived as responsible for their disorder. For this reason, anti-stigma campaigns should be directed to end the misconceptions toward the most discriminated groups. More support is needed to counteract the stigmatization and exclusion of individuals with mental and neurological disorders in our society.
Collapse
|
7
|
Alhelou N, Kavattur PS, Olson MM, Rountree L, Winkler IT. Menstruation, Myopia, and Marginalization: Advancing Menstrual Policies to "Keep Girls in School" at the Risk of Exacerbating Inequalities. Health Hum Rights 2022; 24:13-28. [PMID: 36579303 PMCID: PMC9790947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
As countries across the world adopt policies addressing menstruation, it is imperative to identify who benefits from such policies and to understand the dynamics of inclusion and exclusion. We examine such policies through the lens of human rights, as a framework that demands addressing marginalization, ensuring substantive equality, and guaranteeing inclusive participation to ensure that the menstrual needs of everyone, everywhere are met. Our review is focused on four countries (India, Kenya, Senegal, and the United States) and is based on data from 34 policy documents and interviews with 85 participants. We show that girls, particularly school-going girls, are the main target group of policies. Due to this myopic view of menstrual needs, policies risk leaving the needs of adult menstruators, including those experiencing (peri)menopause, unaddressed. Moreover, the intersection between menstrual status and markers of identity such as disability and gender identity produces further policy gaps. These gaps can be attributed to the exclusion of marginalized menstruators from decision-making processes by creating barriers and failing to ensure meaningful inclusive participation. To address inequalities, policy makers need to make a concerted effort to understand and accommodate the needs of menstruators in all their diversity.
Collapse
Affiliation(s)
- Nay Alhelou
- A research coordinator at the Population Council and former research fellow at the Institute for the Study of Human Rights at Columbia University, New York, United States
| | - Purvaja S. Kavattur
- A researcher with the National Advocates for Pregnant Women, and former staff associate at the Institute for the Study of Human Rights at Columbia University, New York, United States
| | - Mary M. Olson
- A researcher at Columbia University, New York, United States, specializing in economics and its intersections with human rights and gender
| | - Lillian Rountree
- An undergraduate at Columbia University, New York, United States, studies statistics and French with a research focus on menstrual health and contraception
| | - Inga T. Winkler
- An associate professor in human rights in the Legal Studies Department at the Central European University in Vienna, Austria, and former lecturer in human rights at Columbia University, New York, United States
| |
Collapse
|
8
|
Mengual-Pujante M, Morán-Sánchez I, Luna-Ruiz Cabello A, Pérez-Cárceles MD. Attitudes of the police towards individuals with a known psychiatric diagnosis. BMC Psychiatry 2022; 22:614. [PMID: 36123659 PMCID: PMC9484251 DOI: 10.1186/s12888-022-04234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 08/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Police officers are increasingly required to respond to incidents involving psychiatric patients. However, few studies have assessed whether the attitude of police officers depends on prior knowledge of their specific psychiatric diagnosis. Our aim was to analyze the effects of psychiatric diagnosis on the behavior of police officers. METHODS We utilized the Attribution Questionnaire adapted to the police context to examine the attitudes of 927 officers of the Spanish National Police Force towards persons diagnosed with either schizophrenia or depressive disorder playing the role of somebody in need of assistance, a victim of a crime, a witness, or a suspect in a criminal case. Different socio-demographic variables were also collected. RESULTS Compared to attitudes to individuals with a known psychiatric diagnosis, police officers expressed increased willingness to help psychiatric patients and increased sympathy and attributing to them less responsibility for their actions. They also showed increased feelings of avoidance, reported a greater perception of danger and a greater need for isolation and involuntary treatment. This was especially so in the case of schizophrenia. Stigmatizing attitudes were less apparent when the person was a woman, a veteran officer, or someone with a history of work experience. CONCLUSIONS Police officers may hold certain stigmatizing attitudes towards persons with mental illness, particularly schizophrenia, that require special attention, as they may negatively affect police action. We found several factors associated with the persistence of these stigmatizing attitudes among police officers that may guide us when implementing training programs for promoting attitude change, especially at the beginning of an officer's professional career.
Collapse
Affiliation(s)
- M. Mengual-Pujante
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - I. Morán-Sánchez
- Cartagena Mental Health Centre, Real St 8, E-30201, Cartagena, Murcia, Spain ,grid.411967.c0000 0001 2288 3068Department of Forensic Psychiatry, Law Faculty, Catholic University of Murcia, Murcia, Spain
| | - A. Luna-Ruiz Cabello
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - M. D. Pérez-Cárceles
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
| |
Collapse
|
9
|
Almeida B, Samouco A, Grilo F, Pimenta S, Moreira AM. Prescribing stigma in mental disorders: A comparative study of Portuguese psychiatrists and general practitioners. Int J Soc Psychiatry 2022; 68:708-717. [PMID: 33730898 DOI: 10.1177/00207640211002558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Physicians, including psychiatrists and general practitioners (GPs), have been reported as essential sources of stigma towards people diagnosed with a mental disorder (PDMDs), which constitutes an important barrier to recovery and is associated with poorer clinical outcomes. Therefore, psychiatrists and GPs are key populations where it is crucial to examine stigma, improve attitudes and reduce discrimination towards psychiatric patients. AIMS This study is the first to explore mental health-related stigma among Portuguese psychiatrists and GPs, examining the differences between these two specialities and assessing whether sociodemographic and professional variables are associated with stigma. METHOD A cross-sectional study was performed between June 2018 and August 2019. A consecutive sample of 55 Psychiatrists and 67 GPs working in Porto (Portugal) filled a 25-item self-report questionnaire to assess their attitudes towards PDMDs in clinical practice. The instrument was designed by the authors, based on previous mental health-related stigma studies and validated scales. The questionnaire includes 12 stigma dimensions (Autonomy, Coercion, Incompetence, Dangerousness, Permanence, Pity, Responsibility, Segregation, Labelling, Diagnostic Overshadowing, Shame and Parental Incompetence), and its total score was used to measure Overall Stigma (OS). Sample characteristics were examined using descriptive statistics, and the factors affecting stigma were assessed through regression analysis. RESULTS GPs exhibit significantly higher OS levels than psychiatrists, and present higher scores in the dimensions of dangerousness, parental incompetence, diagnostic overshadowing and responsibility. Besides medical speciality, several other sociodemographic variables were associated with sigma, including age, gender, having a friend with a mental disorder, professional category, agreement that Psychiatry diverges from core medicine and physician's interest in mental health topics. CONCLUSIONS Our data suggest that both psychiatrists and GPs hold some degree of stigmatizing attitudes towards PDMDs. Overall, these results bring new light to stigma research, and provide information to tailor anti-stigma interventions to Portuguese psychiatrists and GPs.
Collapse
Affiliation(s)
| | - Ana Samouco
- Unidade Local de Saúde do Norte Alentejano EPE, Portalegre, Portugal
| | - Filipe Grilo
- Departamento de Economia, Faculdade de Economia da Universidade do Porto, Portugal
| | - Sónia Pimenta
- Electroconvulsive Therapy Unit, Hospital de Magalhães Lemos EPE, Porto, Portugal
| | - Ana Maria Moreira
- Community Mental Health Service, Hospital de Magalhães Lemos EPE, Porto, Portugal
| |
Collapse
|
10
|
Husain MO, Khoso AB, Renwick L, Kiran T, Saeed S, Lane S, Naeem F, Chaudhry IB, Husain N. Culturally adapted family intervention for schizophrenia in Pakistan: a feasibility study. Int J Psychiatry Clin Pract 2021; 25:258-267. [PMID: 32930011 DOI: 10.1080/13651501.2020.1819332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To establish feasibility and acceptability of a Culturally adapted Family Intervention (CulFI) that was developed using an empirically derived conceptual framework in Pakistan. METHODS A rater-blind, randomised trial to evaluate the feasibility and acceptability of delivering CulFI compared to treatment as usual in Karachi, Pakistan. Indicators of feasibility included evaluation of recruitment rates, retention and randomisation. We also evaluated the acceptability of the intervention and trial procedures. RESULTS Excellent recruitment and retention rates informed the feasibility of the intervention. CulFI had more than a 90% participant attendance of 8-10 sessions and retained more than 90% who commenced in the intervention. Eighty percent of those who initially provided consent were willing to be randomised and the quality of CulFI was rated as good to excellent by 85.7% of participants. CONCLUSIONS Importantly, this study determines that pathways into a psychosocial intervention can be established in Pakistan. A combination of factors contribute to low levels of access to psychiatric care including different explanatory models of illness, small numbers of trained staff, limited resources and reliance on traditional healers. These results support the feasibility, acceptability and merit of conducting a full-scale trial of CulFI in comparison with standard care.ClinicalTrials.gov Identifier: NCT02167347KEY POINTSThe significant treatment gap in LMICs leaves families providing much of the care for people with schizophrenia.There is limited evidence from LMICs supporting the effectiveness and feasibility of psychosocial interventions more broadly, and family interventions specifically.This study adds to the scarce literature and demonstrates that pathways into delivering psychosocial interventions can be established in Pakistan.The results of this trial support the feasibility and acceptability of a Culturally adapted Family Intervention (CulFI) for schizophrenia patients and their families in PakistanA full-scale trial of CulFI in comparison with standard care is warranted to determine clinical and cost-effectiveness.
Collapse
Affiliation(s)
- Muhammad Omair Husain
- School of Biological Sciences, University of Manchester, Manchester, UK.,Pakistan Institute of Living and Learning, Karachi, Pakistan.,Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Ameer B Khoso
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Laoise Renwick
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Tayyeba Kiran
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Sofiya Saeed
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Steven Lane
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Farooq Naeem
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Imran B Chaudhry
- School of Biological Sciences, University of Manchester, Manchester, UK.,Pakistan Institute of Living and Learning, Karachi, Pakistan.,Department of Psychiatry, Ziauddin Hospital, Karachi, Pakistan
| | - Nusrat Husain
- School of Health Sciences, University of Manchester, Manchester, UK
| |
Collapse
|