October 25, 2007

Prognosis for Schizophrenia Better in Developing Countries?

The Schizophrenia Research Forum holds online discussions where the editors of Schizophrenia Bulletin feature an entire research article along with an introduction. Their most recent featured article examines whether people with schizophrenia in the developing world are truly better off than those with the same illness in the developed world.

For the article, researcher "Alex Cohen and colleagues...review(ed) 23 reports that challenge(d) the view that schizophrenia has a more benign course in developing countries." The idea of schizophrenia faring better for people in developing nations is the result of data collected during the International Pilot Study of Schizophrenia (IPSS). The IPSS found that participants in the developing countries of "Nigeria, Colombia, and India fared better at 2- and 5-year follow-up(s) than patient subjects in five developed countries (WHO, 1979)."

As the introduction points out, the data collected during the IPSS may have been subject to sample bias. Following IPSS, subsequent studies were performed which aimed to eliminate or reduce this bias and still found more positive prognoses in developing countries. However, Cohen and colleagues after their examination of 23 different studies, have discovered that the prognosis of schizophrenia in developing nations is not necessarily more positive than in developed countries:

Good and poor outcomes occur in the same nations. Explanations do not fit neatly into wealth, industrialized, urbanized, or other common explanations. Methodological issues may explain why some data suggest a more favorable course in developing countries. Other patterns emerge, and the authors identify seven questions to be addressed in future research.

Further studies in this area may provide insight into how loved ones, mental health practitioners and society in general can deal with sufferers of schizophrenia in a more positive way. However, necessary to this possible insight is to first determine whether schizophrenia really does fare better in developing countries.

Source: Schizophrenia Research Forum, Truly Better Prognosis in the Developing World?


Schizophrenia needs lots of support, love, nurturing and
not just tolerance. could it be that many developing nations have more of a extending family surrounding,
more people to deal with MI
with love and care. In a
so called developed nation,
its just the nuclear family
coping with endless stress...
no question of any shortage of love but it can still make the difference.

Posted by: jena at October 26, 2007 02:18 AM

I cant see it...I have money in my pocket..good family...great mental health care...effective meds..generally a good standard of living..i don't think i would be better off and more likely to recover if a lived in a tin hut in a poor village in a developing country.

Posted by: Salty Davis at October 26, 2007 01:37 PM

I agree with Jena. Schizophrenia is a form of disturbed thinking. Being surrounded by great weather (non-stop sunshine, as in many developing countries) and large, loving extended families is a formula for making anyone feel better or improve in their health and outlook. Jena knows what she is talking about, but that's just my opinion.

Posted by: hmmned at October 29, 2007 10:43 AM

In my opinion it is adapting to ones culture, such as Ely Saks, the law professor. Faith or religion is much more of an influence in some country whereas US has freedom of choice and seperated church and state in their Bill of Rights. That can be determined as a factor in how one is raised and what they believe.

Posted by: J D at November 2, 2007 03:29 PM

With reference to my work at www.schizophreniaforum.org commenting after Jonathan Burns, I would like to add to the fact that the supportive and insight-oriented theraphy in Third World Contries, like Indonesia, the place of my Motherland is embedded in the externalities and society. So the function of many cousins and uncles provide safety net for the patients. Of Course, this opinion is provided by basic assumption that the family can afford more or less, haloperidol or clozapine or risperidone intra muscular for 10 years.

Suhari Bunadi BSc
Teaching Assistant
at Massachusetts Institute of Technology,
Open Learning Support,
Forum electricity and Magnetism

and search for the name : suhari bunadi

Posted by: suhari bunadi at November 9, 2007 12:12 AM

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