Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Nov;195(5):433-9.
doi: 10.1192/bjp.bp.108.057596.

Outcomes of people with psychotic disorders in a community-based rehabilitation programme in rural India

Sudipto Chatterjee  1 , Aravind Pillai, Sumeet Jain, Alex Cohen, Vikram Patel
Affiliations

Outcomes of people with psychotic disorders in a community-based rehabilitation programme in rural India

Sudipto Chatterjee et al. Br J Psychiatry. 2009 Nov.

Abstract

Background: There is little evidence of the feasibility, acceptability and impact of services for the care of people with psychotic disorders in low- and middle-income countries.

Aims: To describe the scaling up and impact of a community-based rehabilitation programme for people with psychotic disorders in a very-low-resource setting.

Methods: Longitudinal study of people with psychotic disorders who had been ill for an average of 8 years in a rural Indian community. All individuals received a community-based intervention package comprising psychotropic medications, psychoeducation, adherence management, psychosocial rehabilitation and support for livelihoods. The primary outcome was change in disability scores.

Results: The cohort consisted of 256 people with psychotic disorders (schizophrenia, bipolar affective disorder and other psychosis) of whom 236 people completed the end-point assessments (92%), with a median follow-up of 46 months. There were significant reductions (P<0.05) in the levels of disability for the cohort, the vast majority (83.5%) of whom engaged with the programme. On multivariate analyses, lower baseline disability scores, family engagement with the programme, medication adherence and being a member of a self-help group were independent determinants of good outcomes. Lack of formal education, a diagnosis of schizophrenia and dropping out of the programme were independent determinants of poor outcomes.

Conclusions: Community-based rehabilitation is a feasible and acceptable intervention with a beneficial impact on disability for the majority of people with psychotic disorders in low-resource settings. The impact on disability is influenced by a combination of clinical, programme and social determinants.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Referral pattern of the community-based rehabilitation programme over time.
See this image and copyright information in PMC

References

    1. World Health Organization. The World Health Report 2001. Mental Health: New Understanding, New Hope. WHO, 2001.
    1. Saxena S, Sharan P, Garrido M, Saraceno B. World Health Organization’s Mental Health Atlas 2005: implications for policy development. World Psychiatry 2006; 5: 179–84. - PMC - PubMed
    1. Hyman S, Chisholm D, Kessler R, Patel V, Whiteford H. Mental disorders. In Disease Control Priorities in Developing Countries (2nd edn) (eds DT Jamison, JG Breman, AR Measham, G Alleyne, M Cleason, DB Evans, et al): 605–25. Oxford University Press, 2006.
    1. Saraceno B, van Ommeren M, Batniji R, Cohen A, Gureje O, Majoney J, et al. Barriers to improvement of mental health services in low-income and middle-income countries. Lancet 2007; 370: 1164–74. - PubMed
    1. Lancet Global Mental Health Group. Scale up services for mental disorders: a call to action. Lancet 2007; 370: 1241–52. - PubMed

Publication types