A systematic review of explanatory models of illness for psychosis in developing countries
A systematic review of explanatory models of illness for psychosis in developing countries
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DOI：
10.3109/09540261.2012.711746
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发表时间：
2012-01-01
影响因子：
2.8
通讯作者：
Husain, Nusrat
中科院分区：
文献类型：
--
作者：
Bhikha, Aqeela G.;Farooq, Saeed;Husain, Nusrat
背景资料：由患者和治疗临床医生持有的疾病解释模型为疾病、治疗评估和选择提供了理由和解释。这些研究与常见的精神障碍有关，但对精神病解释模型（EMOP）的研究很少受到关注。正确理解患者对精神病的解释模型具有重要的临床意义。方法：我们系统地检查了发展中国家关于EMOP的研究，以报告解释模型的性质、它们与寻求帮助的关系、未经治疗的精神病（DUP）的持续时间、感知到的耻辱以及第一次和后续发作之间解释模型的任何差异。结果：确定了14项研究在发展中国家审查EMOP。大多数研究报告主要是超自然和心理社会EMOP。持有超自然和心理社会的解释模型影响求助行为，治疗方式和DUP。讨论：发展中国家的EMOP是丰富多样的。文献报告了使用不同方法的各种人群，并受到方法上的限制。最近的一些研究也试图通过教育干预来修改解释模型;然而，这并没有在患者人群中进行研究。需要进一步的研究来检验不同的解释模型对DUP和求助行为的影响。
Background: Explanatory models of illness, held by patients and treating clinicians, offer justifications and propose explanations for sickness, treatment evaluations and choice. These have been studied in relation to common mental disorders but research on explanatory models of psychosis (EMOP) has received scant attention. Adequately understanding patients' explanatory models for psychosis has important clinical implications. Method: We systematically examined studies on EMOP in the developing world to report on the nature of explanatory models, their relationship with help-seeking, duration of untreated psychosis (DUP), perceived stigma and any differences in the explanatory models between first and subsequent episodes. Results: 14 studies examining EMOP in developing countries were identified. The majority of studies reported predominantly supernatural and psychosocial EMOP. Holding supernatural and psychosocial explanatory models affected help-seeking behaviour, treatment modalities used and DUP. Discussion: EMOP in developing countries are rich and varied. The literature reports on a variety of populations using different methods and suffers from methodological limitations. Some recent studies have also attempted to modify explanatory models by using educational interventions; however, this was not examined in patient populations. Further research is needed to examine the impact of different explanatory models on DUP and help-seeking behaviours.