Context and Expectations Matter: Social, Recreational, and Independent Functioning among Youth with Psychosis in Chennai, India and Montreal, Canada.
Context and Expectations Matter: Social, Recreational, and Independent Functioning among Youth with Psychosis in Chennai, India and Montreal, Canada.
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DOI：
10.1177/07067437231153796
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发表时间：
2023-10
影响因子：
4
通讯作者：
Malla, Ashok
中科院分区：
文献类型：
--
作者：
Iyer, Srividya N. N.;Rangaswamy, Thara;Mustafa, Sally;Pawliuk, Nicole;Mohan, Greeshma;Joober, Ridha;Schmitz, Norbert;Margolese, Howard;Padmavati, Ramachandran;Malla, Ashok
大多数跨文化精神病研究都集中在有限数量的结果(通常与症状相关)和视角(通常是临床医生/观察者评级)。目前尚不清楚，在一些低收入和中等收入国家，精神病的所谓优越结果是否延伸到患者报告的社交、娱乐和独立功能的衡量标准。为了解决这一差距，这项研究旨在比较高收入地点和较低中等收入地点首发精神病的这些结果。在印度金奈(N = 164)和加拿大蒙特利尔(N = 140)接受类似设计的精神病早期干预的患者完成了自我报告的社会功能量表-早期干预，该量表衡量亲社会、娱乐和独立-表现功能。他们的案例经理对预期的独立性-表现功能进行了评级。这两组评估都是在入院时以及第6、18和24个月进行的。对不同地点和不同时间的差异进行了线性混合模型分析，考虑了其他相关变量，特别是阴性症状。线性混合模型显示，蒙特利尔的亲社会、娱乐和独立-表现功能得分显著高于金奈，并且不随时间变化。预期的独立性-蒙特利尔的表现也更高，并随着时间的推移而增加。阴性症状和教育独立地预测亲社会、娱乐和预期的独立-表现功能。当添加到模型中时，预期的独立性绩效预测实际的独立性绩效和站点不再显著。在这两个地点，亲社会和娱乐方面的得分(40%)始终低于独立表现(40%-65%)。这是第一次关于早期精神病的亲社会、娱乐和独立功能的跨文化调查。它表明，这些结果因社会文化背景而异。对患者的不同程度的期望，本身受到文化、疾病和社会决定因素的影响，可能会导致功能结果的跨文化差异。在这两个地点，社交、娱乐和独立功能处于低到中等范围，随着时间的推移没有改善，强调需要专门为影响这些结果而设计的有效干预措施。
Most cross-cultural psychosis research has focused on a limited number of outcomes (generally symptom-related) and perspectives (often clinician-/observer-rated). It is unknown if the purported superior outcomes for psychosis in some low- and middle-income countries extend to patient-reported measures of social, recreational, and independent functioning. Addressing this gap, this study aimed to compare these outcomes in first-episode psychosis at a high-income site and a lower middle-income site. Patients receiving similarly designed early intervention for psychosis in Chennai, India (N = 164) and Montreal, Canada (N = 140) completed the self-reported Social Functioning Scale-Early Intervention, which measures prosocial, recreation, and independence-performance functioning. Their case managers rated expected independence-performance functioning. Both sets of assessments were done at entry and Months 6, 18, and 24. Linear mixed model analyses of differences between sites and over time were conducted, accounting for other pertinent variables, especially negative symptoms. Linear mixed models showed that prosocial, recreation, and independence-performance functioning scores were significantly higher in Montreal than Chennai and did not change over time. Expected independence-performance was also higher in Montreal and increased over time. Negative symptoms and education independently predicted prosocial, recreation, and expected independence-performance functioning. When added to the model, expected independence-performance predicted actual independence-performance and site was no longer significant. At both sites, prosocial and recreation scores were consistently lower (<40%) than independence-performance (40–65%). This is the first cross-cultural investigation of prosocial, recreation, and independent functioning in early psychosis. It demonstrates that these outcomes differ by socio-cultural context. Differing levels of expectations about patients, themselves shaped by cultural, illness, and social determinants, may contribute to cross-cultural variations in functional outcomes. At both sites, social, recreational, and independent functioning were in the low-to-moderate range and there was no improvement over time, underscoring the need for effective interventions specifically designed to impact these outcomes.
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影响因子：
1.9
作者：
Iyer, Srividya N.;Malla, Ashok;Taksal, Aarati;Pawliuk, Nicole;Mangala, Ramamurti;Mohan, Greeshma;Pope, Megan A.;Schmitz, Norbert;Loohuis, Heleen;Padmavati, Ramachandran;Joober, Ridha;Shah, Jai;Rangaswamy, Thara
通讯作者：
Rangaswamy, Thara
影响因子：
3.7
作者：
Abdin, Edimansyah;Chong, Siow Ann;Subramaniam, Mythily
通讯作者：
Subramaniam, Mythily
影响因子：
2
作者：
Chudleigh, Catherine;Naismith, Sharon L.;Hickie, Ian B.
通讯作者：
Hickie, Ian B.
DOI：
10.1080/15487768.2014.909683
发表时间：
2014-01-01
期刊：
AMERICAN JOURNAL OF PSYCHIATRIC REHABILITATION
影响因子：
--
作者：
Iwasaki, Yoshitaka;Coyle, Catherine;Koons, Glenn
通讯作者：
Koons, Glenn
影响因子：
4.5
作者：
Goulding SM;Franz L;Bergner E;Compton MT
通讯作者：
Compton MT