scholarly journals Assessing cognition in people with severe mental disorders in low- and middle-income countries: a systematic review of assessment measures

Author(s):  
Yohannes Gebreegziabhere Haile ◽  
Kassahun Habatmu ◽  
Andualem Derese ◽  
Hetta Gouse ◽  
Stephen M. Lawrie ◽  
...  

Abstract Background Cognitive difficulties are common in people with severe mental disorders (SMDs) and various measures of cognition are of proven validity. However, there is a lack of systematic evidence regarding the psychometric properties of these measures in low- and middle-income countries (LMICs). Objective To systematically review the psychometric properties of cognitive measures validated in people with SMDs in LMICs. Methods We conducted a systematic review of the literature by searching from four electronic databases. Two authors independently screened studies for their eligibility. Measurement properties of measures in all included studies were extracted. All eligible measures were assessed against criteria set for clinical and research recommendations. Results are summarized narratively and measures were grouped by measurement type and population. Results We identified 23 unique measures from 28 studies. None of these was from low-income settings. Seventeen of the measures were performance-based. The majority (n = 16/23) of the measures were validated in people with schizophrenia. The most commonly reported measurement properties were: known group, convergent, and divergent validity (n = 25/28). For most psychometric property, studies of methodological qualities were found to be doubtful. Among measures evaluated in people with schizophrenia, Brief Assessment of Cognition in Schizophrenia, Cognitive Assessment Interview, MATRICS Consensus Cognitive Battery, and CogState Schizophrenia Battery were with the highest scores for clinical and research recommendation. Conclusions Studies included in our review provide only limited quality evidence and future studies should consider adapting and validating measures using stronger designs and methods. Nonetheless, validated assessments of cognition could help in the management and allocating therapy in people with SMDs in LMICs.

BJPsych Open ◽  
2018 ◽  
Vol 4 (5) ◽  
pp. 375-384 ◽  
Author(s):  
Mekdes Demissie ◽  
Charlotte Hanlon ◽  
Rahel Birhane ◽  
Lauren Ng ◽  
Girmay Medhin ◽  
...  

BackgroundAdjunctive psychological interventions for bipolar disorder have demonstrated better efficacy in preventing or delaying relapse and improving outcomes compared with pharmacotherapy alone.AimsTo evaluate the efficacy of psychological interventions for bipolar disorder in low- and middle-income countries.MethodA systematic review was conducted using PubMed, PsycINFO, Medline, EMBASE, Cochrane database for systematic review, Cochrane central register of controlled trials, Latin America and Caribbean Center on Health Science Literature and African Journals Online databases with no restriction of language or year of publication. Methodological heterogeneity of studies precluded meta-analysis.ResultsA total of 18 adjunctive studies were identified: psychoeducation (n = 14), family intervention (n = 1), group cognitive–behavioural therapy (CBT) (n = 2) and group mindfulness-based cognitive therapy (MBCT) (n = 1). In total, 16 of the 18 studies were from upper-middle-income countries and none from low-income countries. All used mental health specialists or experienced therapists to deliver the intervention. Most of the studies have moderately high risk of bias. Psychoeducation improved treatment adherence, knowledge of and attitudes towards bipolar disorder and quality of life, and led to decreased relapse rates and hospital admissions. Family psychoeducation prevented relapse, decreased hospital admissions and improved medication adherence. CBT reduced both depressive and manic symptoms. MBCT reduced emotional dysregulation.ConclusionsAdjunctive psychological interventions alongside pharmacotherapy appear to improve the clinical outcome and quality of life of people with bipolar disorder in middle-income countries. Further studies are required to investigate contextual adaptation and the role of non-specialists in the provision of psychological interventions to ensure scalability and the efficacy of these interventions in low-income country settings.Declaration of interestNone.


2010 ◽  
Vol 71 (3) ◽  
pp. 517-528 ◽  
Author(s):  
Crick Lund ◽  
Alison Breen ◽  
Alan J. Flisher ◽  
Ritsuko Kakuma ◽  
Joanne Corrigall ◽  
...  

2021 ◽  
pp. 1476718X2110200
Author(s):  
Bernardita Munoz-Chereau ◽  
Lynn Ang ◽  
Julie Dockrell ◽  
Laura Outhwaite ◽  
Claire Heffernan

The Sustainable Development Goals mandate that by 2030, all children should have access to quality early child development opportunities, healthcare and pre-primary education. Yet validated measures of ECD in low and middle income countries (LMICs) are rare. To address this gap, a Systematic Review (SR) of measures available to profile the development of children between the ages of 0–5 years in LMICs was undertaken. Drawing on education, psychology and health databases, we identified reliable, valid or measures adapted for use in LMICs for either assessments of children’s development or their learning environments. The inclusion criteria were (1) peer reviewed papers published between January 2009 and May 2019; (2) assessment tools used to measure cognitive/language development or the early years or home environment in at least one LMIC; (3) report of the psychometric properties (validity and reliability) of the tool, and/or description of the cultural adaptability/translation process undertaken before applying it to a LMIC. Two hundred and forty-nine available records published in the last decade in peer-review journals and nine relevant systematic literature reviews were identified. Fifty-seven records were qualitatively synthesised based on their psychometric properties and cultural adaptation. Forty-three tools were reviewed utilising 12 criteria. Five elements of analysis present in Tables 2 and 3 (study, population tested, validity, reliability and cultural adaptability/translation) focused on the tools’ psychometric properties and previous application in LMICs. A further seven dimensions outlined in Tables 4 and 5 identified specific characteristics of the tools from target age, administration method, domains, battery, accessibility, language and country/institution. We suggest these 12 key considerations for the selection of measurement tools that are applicable to effectively assess ECD in LMICs.


2021 ◽  
Vol 6 (8) ◽  

Background: Accessibility to healthcare is the capability of a population to obtain a specified set of healthcare services. There is a direct link between the distance patients travel to access health and the reduction of ill health and suffering in a country. This has an important impact on the quality of life of people. Objective: To find the spatial or geographic determinants of accessibility of primary healthcare provision in low and middle income countries during last two decades. Methods: Systematic review was done according to PRISMA guidelines. Data bases used were Google scholar, PubMed and Science direct. We found ten different studies from eight different economic groups of countries. Accessibility of primary healthcare in low and middle Income countries published during the period of last two decades were included using the key words like Spatial Accessibility;Geographical Accessibility; Primary Health Care; Primary Care; Low and middle income countries. The countries included were Afghanistan, Bangladesh, Bhutan, Democratic Republic of Congo, India, Indonesia, Sudan, Mozambique /Rural Africa. Two studies each from India and Mozambique (Rural Africa) were included. The categorization as low and middle income counties was as per World Bank classification. Results: We found that accessibility to primary healthcare was worse in low income countries like Afghanistan, Mozambique and South Sudan where more than two third of the population lived in underserved or difficult to access areas while rest of the countries, which come under category of lower middle income countries, more than half of the population lived in underserved or difficult to access areas.] Conclusion: Health care ease of access is a single most important component for equitable and adequate health system. Guaranteeing a healthcare system which is easily accessible to the people is a basic consideration for public health policy makers, policy implementers and academicians.


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