The incidence of psychoses in diverse settings, INTREPID (2): a feasibility study in India, Nigeria, and Trinidad.

BACKGROUND: There are striking global inequities in our knowledge of the incidence, aetiology, and outcome of psychotic disorders. For example, only around 10% of research on incidence of psychotic disorders originates in low- and middle-income countries. We established INTREPID I to develop, implement, and evaluate, in sites in India (Chengalpet), Nigeria (Ibadan), and Trinidad (Tunapuna-Piarco), methods for identifying and recruiting untreated cases of psychosis, as a basis for investigating incidence and, subsequently, risk factors, phenomenology, and outcome. In this paper, we compare case characteristics and incidence rates across the sites. METHOD: In each site, to identify untreated cases of psychoses in defined catchment areas, we established case detection systems comprising mental health services, traditional and spiritual healers, and key informants. RESULTS: Rates of all untreated psychoses were 45.9 (per 1 00 000 person-years) in Chengalpet, 31.2 in Ibadan, and 36.9 in Tunapuna-Piarco. Duration of psychosis prior to detection was substantially longer in Chengalpet (median 232 weeks) than in Ibadan (median 13 weeks) and Tunapuna-Piarco (median 38 weeks). When analyses were restricted to cases with a short duration (i.e. onset within preceding 2 years) only, rates were 15.5 in Chengalpet, 29.1 in Ibadan, and 26.5 in Tunapuna-Piarco. Further, there was evidence of age and sex differences across sites, with an older average age of onset in Chengalpet and higher rates among women in Ibadan. CONCLUSION: Our findings suggest there may be differences in rates of psychoses and in the clinical and demographic profiles of cases across economically and socially distinct settings

Evaluating music therapy in adult mental health services: Tuning into service user perspectives

Many statutory mental health services worldwide have adopted a recovery-oriented rhetoric. These acknowledge that those who use mental health services have acquired valuable expertise through their contact with services and that such expertise should be used to inform health provision. The focus of this study was to tune into the perspectives of adult service users who have attended music therapy in statutory mental health services in Ireland. This aimed to furnish holistic descriptions of practice so as to augment existing understanding of what may be afforded to those who attend music therapy sessions. Six service users participated in semi-structured interviews in which they described their lived experience of attending music therapy sessions. Interview transcripts were analysed using interpretative phenomenological analysis. Six common themes were found across each of the six participant cases. These included \u27Music therapy offers an opportunity to be meaningfully occupied\u27, \u27Involvement in music therapy can pose challenges\u27, \u27Music therapy offers an agreeable process\u27, \u27Group music therapy fosters reciprocity\u27, \u27Music therapy is flexible and adaptable\u27 and \u27Lack of musical instruction can cause frustration\u27. Findings relating to meaningful occupation, challenge, reciprocity and frustration broaden understanding of what music therapy can offer to service users in mental health provision. (PsycINFO Database Record (c) 2018 APA, all rights reserved