Shanthi Johnson|Manoranjitham Sathyaseelan|Helen Charles|Visalakshi Jeyaseelan|K Jacob
Insight, psychopathology, explanatory models and outcome of schizophrenia in India: a prospective 5-year cohort study
Christian Medical College & Hospital|Christian Medical College & Hospital|Christian Medical College & Hospital|Christian Medical College & Hospital|Christian Medical College & Hospital
abstract background sole focus models insight biomedical perspectives complete exclusion local nonmedical cultural constructs mandates review study attempted investigate impact insight psychopathology explanatory models illness outcome first episode schizophrenia method patients diagnosed dsm iv schizophrenia n 131 assessed prospectively insight psychopathology explanatory models illness baseline 6 12 60 months using standard instruments multiple linear logistic regression generalized estimating equations gee employed assess predictors outcome results could follow 95 725 patients sixtyfive patients 684 achieved remission negative relationship psychosis rating insight scores urban residence fluctuating course initial illness improvement global functioning 6 months lower psychosis rating 12 months significantly related remission 5 years insight scores number nonmedical explanatory models individual explanatory models held later course illness significantly associated outcome analysis longitudinal data using gee showed women rural residence insight scores number nonmedical explanatory models illness held significantly associated bprs scores study period conclusions insight disease model number nonmedical model positively correlated improvement psychosis arguing complex interaction culture context illness variables finding argue insight explanatory models secondary psychopathology course outcome illness awareness mental illness narrative act people make personal sense many challenges face course outcome illness cultural context acceptable cultural explanations prevalent social stigma interact produce complex multifaceted understanding issues complexity calls nuanced framing insight