1.Psychiatrists’ Perceptions Of What Determines Outcomes For People Diagnosed With Schizophrenia In Vietnam
Seiji H Humphries ; Robert J King ; Michael P Dunne ; Nguyen H Cat
ASEAN Journal of Psychiatry 2015;16(2):1-12
Objectives: Research about the outcomes of schizophrenia and the factors that
determine them in developing countries is still limited. In this study, we
interviewed experienced Vietnamese psychiatrists to examine their perspectives
on outcome determinants in their country. The qualitative approach aimed to
complement existing epidemiological knowledge and contribute to debate around
the hypothesis that recovery is better in developing countries. Methods: Fifteen
Vietnamese psychiatrists working in five leading psychiatric facilities
participated in semi-structured interviews. Thematic content analysis of their
expressed views identified three themes related to important outcome
determinants in Vietnam: access to contemporary treatment, established patientlevel
prognostic indicators, and sociocultural variables. Results: The improving
accessibility of modern treatment (including new medications, specialist staff and
facilities) and increasing community adoption of a medical perspective on mental
illness were seen as factors leading to improved outcomes, particularly in urban
areas. However, some psychiatrists also identified the potentially beneficial
nature of some aspects of Vietnamese society and culture being eroded by
modernization, including traditional family structures, forms of employment and
lifestyles. Conclusions: The perspectives of psychiatrists in this study suggest that
socioeconomic change may be exerting conflicting influences on the outcomes of
schizophrenia in Vietnam and other developing countries. Their views have
implications in terms of how adequate treatment and support for people with
severe mental illness can be provided in the context of limited resources, staffing
and formal treatment options. Further research is needed to establish current
recovery rates and prospectively explore the impact of modernization on
outcomes.