The incidence of psychoses in diverse settings, INTREPID (2): a feasibility study in India, Nigeria, and Trinidad
The incidence of psychoses in diverse settings, INTREPID (2): a feasibility study in India, Nigeria, and Trinidad
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DOI：
10.1017/s0033291716000441
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发表时间：
2016-07-01
影响因子：
6.9
通讯作者：
Cohen, A.
中科院分区：
文献类型：
--
作者：
Morgan, C.;John, S.;Cohen, A.
背景。在我们对精神疾病的发病率、病因和结果的认识上，全球存在着惊人的不平等。例如，关于精神障碍发病率的研究中只有大约10%来自低收入和中等收入国家。我们在印度（Chengalpet）、尼日利亚（Ibadan）和特立尼达（Tunapuna-Piarco）建立了INTREPID I，以开发、实施和评估识别和招募未经治疗的精神病病例的方法，作为调查发病率以及随后的风险因素、现象和结果的基础。在本文中，我们比较了不同地点的病例特征和发病率。在每个站点，为了在确定的集水区确定未经治疗的精神病病例，我们建立了病例检测系统，包括精神卫生服务、传统和精神治疗师以及关键举报人。所有未经治疗的精神病发病率在Chengalpet为45.9（每10万人年），在Ibadan为31.2，在Tunapuna-Piarco为36.9。在检测前，Chengalpet的精神病持续时间（中位232周）明显长于Ibadan（中位13周）和Tunapuna-Piarco（中位38周）。当分析仅限于病程较短（即发病前2年内）的病例时，Chengalpet的发病率为15.5%，Ibadan为29.1%，tunappuna - piarco为26.5。此外，有证据表明不同地点的年龄和性别存在差异，Chengalpet的平均发病年龄较大，而ibadan的女性发病率较高。我们的研究结果表明，在不同的经济和社会背景下，精神病发病率以及病例的临床和人口统计学特征可能存在差异。
Background. There are striking global inequities in our knowledge of the incidence, aetiology, and outcome of psychotic disorders. For example, only around 10% of research on incidence of psychotic disorders originates in low- and middle-income countries. We established INTREPID I to develop, implement, and evaluate, in sites in India (Chengalpet), Nigeria (Ibadan), and Trinidad (Tunapuna-Piarco), methods for identifying and recruiting untreated cases of psychosis, as a basis for investigating incidence and, subsequently, risk factors, phenomenology, and outcome. In this paper, we compare case characteristics and incidence rates across the sites.Method. In each site, to identify untreated cases of psychoses in defined catchment areas, we established case detection systems comprising mental health services, traditional and spiritual healers, and key informants.Results. Rates of all untreated psychoses were 45.9 (per 1 00 000 person-years) in Chengalpet, 31.2 in Ibadan, and 36.9 in Tunapuna-Piarco. Duration of psychosis prior to detection was substantially longer in Chengalpet (median 232 weeks) than in Ibadan (median 13 weeks) and Tunapuna-Piarco (median 38 weeks). When analyses were restricted to cases with a short duration (i.e. onset within preceding 2 years) only, rates were 15.5 in Chengalpet, 29.1 in Ibadan, and 26.5 in Tunapuna-Piarco. Further, there was evidence of age and sex differences across sites, with an older average age of onset in Chengalpet and higher rates among women in Ibadan.Conclusion. Our findings suggest there may be differences in rates of psychoses and in the clinical and demographic profiles of cases across economically and socially distinct settings.