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Pathways to care in first-episode psychosis in low-resource settings: Implications for policy and practice.
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Singh, Swaran P., Winsper, Catherine, Mohan, Mohapradeep, Birchwood, Max, Chadda, Rakesh K., Furtado, Vivek, Iyer, Srividya N., Lilford, Richard J., Madan, Jason, Meyer, Caroline, Ramachandran, Padmavati, Rangaswamy, Thara, Shah, Jai and Sood, Mamta (2023) Pathways to care in first-episode psychosis in low-resource settings: Implications for policy and practice. Asian Journal of Psychiatry, 81 . 103463. doi:10.1016/j.ajp.2023.103463 ISSN 1876-2018.
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Official URL: https://doi.org/10.1016/j.ajp.2023.103463
Abstract
Developing countries such as India face a major mental health care gap. Delayed or inadequate care can have a profound impact on treatment outcomes. We compared pathways to care in first episode psychosis (FEP) between North and South India to inform solutions to bridge the treatment gap. Cross-sectional observation study of 'untreated' FEP patients (n = 177) visiting a psychiatry department in two sites in India (AIIMS, New Delhi and SCARF, Chennai). We compared duration of untreated psychosis (DUP), first service encounters, illness attributions and socio-demographic factors between patients from North and South India. Correlates of DUP were explored using logistic regression analysis (DUP ≥ 6 months) and generalised linear models (DUP in weeks). Patients in North India had experienced longer DUP than patients in South India (β = 17.68, p < 0.05). The most common first encounter in North India was with a faith healer (45.7%), however, this contact was not significantly associated with longer DUP. Visiting a faith healer was the second most common first contact in South India (23.6%) and was significantly associated with longer DUP (Odds Ratio: 6.84; 95% Confidence Interval: 1.77, 26.49). Being in paid employment was significantly associated with shorter DUP across both sites. Implementing early intervention strategies in a diverse country like India requires careful attention to local population demographics; one size may not fit all. A collaborative relationship between faith healers and mental health professionals could help with educational initiatives and to provide more accessible care. [Abstract copyright: Copyright © 2023. Published by Elsevier B.V.]
Item Type: | Journal Article | ||||||
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Divisions: | Administration > University Executive Office Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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SWORD Depositor: | Library Publications Router | ||||||
Journal or Publication Title: | Asian Journal of Psychiatry | ||||||
Publisher: | Elsevier | ||||||
ISSN: | 1876-2018 | ||||||
Official Date: | March 2023 | ||||||
Dates: |
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Volume: | 81 | ||||||
Article Number: | 103463 | ||||||
DOI: | 10.1016/j.ajp.2023.103463 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Re-use Statement: | ** From PubMed via Jisc Publications Router ** History: received 11-11-2022; revised 22-12-2022; accepted 10-01-2023. | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 21 February 2023 | ||||||
Date of first compliant Open Access: | 21 February 2023 |
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