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Byline: Anindya. Banerjee, Suresh. Kumar, Parmanand. Kulhara, Amod. Gupta Aims: To estimate depression in patients with age-related macular degeneration (AMD) and study the relationships among depression, visual acuity, and disability. [...]

AbstractPsychiatric disorders in India are often attributed to influence of supernatural phenomena, and many patients are subjected to various kinds of ‘magico-religious’ treatments. We studied 40 cases of schizophrenia and ascertained magico-religious beliefs held by their key relatives. The effects of such magico-religious beliefs on psychopathology and treatment-seeking behaviour were explored. The sample were schizophrenia patients diagnosed according to ICD-10 of the World Health Organisation. Psychopathology was assessed on the 9th version of the Present State Examination (PSE-9). Supernatural Attitude Questionnaire was administered to the key relatives of the patients to ascertain their beliefs about various supernatural phenomena and magico-religious treatments. It was observed that the majority of the patients had undergone magico-religious treatment (n = 23). Nearly 74% of the patients who had symptoms coloured by cultural influences such as delusional explanation in terms of paranormal phenomena had undergone magico-religious treatment. It was also seen that though many relatives denied personal conviction in such magico-religious beliefs, yet they sought some kind of magico-religious treatment for the patients. The prevalence of culturally influenced delusions as defined by the PSE-9 was very low. Belief in supernatural influences is common in patients’ relatives from urban background and with adequate education, and treatment based upon such beliefs is sought to a considerable extent in such cases. Local and community belief in such phenomena appeared to be a factor in influencing the decision to seek magico-religious treatment.Copyright © 2000 S. Karger AG, Basel

Summary Post-psychotic depression (PPD) is defined as the development of depression during the phase of remission of schizophrenia. Two groups of DSM-III-R schizophrenics, one with PPD and the other without PPD (30 subjects in each group) were compared. Significantly more patients in PPD group belonged to nuclear families, had longer duration of psychotic phase of the illness, were hospitalised more frequently and had more sadness and anxiety-somatisation during florid illness phase. The PPD group also had more past history of depression. Although PPD patients had better premorbid personal-social adjustment in comparison with non-PPD group, they perceived themselves to be lacking in social support and had experienced more stressful life events. For patients in the PPD group, stepwise multiple regression analysis revealed age of onset, sadness during florid psychotic state, premorbid adjustment, socical support and life events as significant determinants of severity of depression in the post-psychotic phase.

The present paper provides a description of data based and methodologically sound studies of outcome of schizophrenia from developing and non-Western countries and compares the results. Major studies reviewed include the 2- and 5-year follow-up of the cohort of the International Pilot Study of Schizophrenia, the patients of the World Health Organization Collaborative Study on the Determinants of Outcome of Severe Mental Disorders, a few Indian studies including the study sponsored by the Indian Council of Medical Research and some studies from Colombia and South-East Asia. The studies are compared in terms of the quality of methodology and the rate of attrition. Although the outcome criteria of these studies are not similar, it is obvious that the outcome of schizophrenia in developing countries is generally more favourable. The reasons for this are far from clear. Research concerning the issues pertaining to better outcome of schizophrenia in developing countries in the context of socio-cultural differences is woefully lacking. This is an area that deserves research attention.