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      Effectiveness of a community-based intervention for people with schizophrenia and their caregivers in India (COPSI): a randomised controlled trial.

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          Abstract

          Observational evidence suggests that community-based services for people with schizophrenia can be successfully provided by community health workers, when supervised by specialists, in low-income and middle-income countries. We did the COmmunity care for People with Schizophrenia in India (COPSI) trial to compare the effectiveness of a collaborative community-based care intervention with standard facility-based care.

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          The positive and negative syndrome scale (PANSS) for schizophrenia.

          L Opler, Jennifer Kay, Paul Opler … (1986)
          The variable results of positive-negative research with schizophrenics underscore the importance of well-characterized, standardized measurement techniques. We report on the development and initial standardization of the Positive and Negative Syndrome Scale (PANSS) for typological and dimensional assessment. Based on two established psychiatric rating systems, the 30-item PANSS was conceived as an operationalized, drug-sensitive instrument that provides balanced representation of positive and negative symptoms and gauges their relationship to one another and to global psychopathology. It thus constitutes four scales measuring positive and negative syndromes, their differential, and general severity of illness. Study of 101 schizophrenics found the four scales to be normally distributed and supported their reliability and stability. Positive and negative scores were inversely correlated once their common association with general psychopathology was extracted, suggesting that they represent mutually exclusive constructs. Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.
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            Internalized stigma of mental illness: psychometric properties of a new measure.

            Monica Grajales, Jennifer Boyd Ritsher, Poorni Otilingam (2003)
            The study evaluated the Internalized Stigma of Mental Illness (ISMI) scale, designed to measure the subjective experience of stigma, with subscales measuring Alienation, Stereotype Endorsement, Perceived Discrimination, Social Withdrawal and Stigma Resistance. The ISMI was developed in collaboration with people with mental illnesses and contains 29 Likert items. The validation sample included 127 mental health outpatients. Results showed that the ISMI had high internal consistency and test-retest reliability. Construct validity was supported by comparisons against scales measuring related constructs with the same methodology. As expected, the ISMI had positive correlations with measures of stigma beliefs and depressive symptoms, and it had negative correlations with measures of self-esteem, empowerment and recovery orientation. Factor analyses of the joint set of items from the ISMI and each scale supported the distinction between constructs. Having a validated measure of internalized stigma may encourage clinicians to include stigma reduction as a verifiable treatment goal in addition to symptom reduction.
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              Development and psychometric evaluation of the Discrimination and Stigma Scale (DISC).

              Sarah Clement, Norman Sartorius, Elaine Brohan … (2013)
              Mental illness is associated with unfair treatment in a number of areas of life. There is currently no psychometrically validated measure that has been developed to specifically focus on such experienced discrimination. This study aimed to finalise the Discrimination and Stigma Scale (DISC) and establish its psychometric properties. The DISC was further developed using (1) service user and interviewer focus groups; (2) reading ease testing; and (3) cognitive debriefing interviews. The revised scale then underwent psychometric testing to establish the following properties: reliability; validity; precision; acceptability; and feasibility. The final 22-item DISC demonstrated good psychometric properties (n=86) including inter-rater reliability (weighted kappa range: 0.62-0.95), internal consistency (α=0.78) and test-retest reliability (n=46) (weighted kappa range: 0.56-0.89). Feasibility, validity and acceptability were also established. In conclusion, the 22-item DISC is recommended for use in measuring experienced stigma and discrimination. Additional work to develop a measure of anticipated stigma is recommended. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Lancet
                Title: Lancet (London, England)
                Publisher: Elsevier BV
                ISSN (Electronic): 1474-547X
                ISSN (Print): 0140-6736
                Publication date (Electronic): Apr 19 2014
                Volume: 383
                Issue: 9926
                Affiliations
                [1 ] Sangath, Goa, India.
                [2 ] Schizophrenia Research Foundation, Chennai, India.
                [3 ] Parivartan, Satara, India.
                [4 ] King's College London, Institute of Psychiatry, Health Service and Population Research Department, London, UK.
                [5 ] Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India.
                [6 ] Medical Research Council Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK.
                [7 ] Centre for Global Mental Health, Health Service and Population Research Department, London, UK.
                [8 ] Sangath, Goa, India; Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK; Public Health Foundation of India, New Delhi, India.
                [9 ] King's College London, Institute of Psychiatry, Health Service and Population Research Department, London, UK. Electronic address: graham.thornicroft@kcl.ac.uk.
                Article
                Publisher Item ID: S0140-6736(13)62629-X
                DOI: 10.1016/S0140-6736(13)62629-X
                PMC ID: 4255067
                PubMed ID: 24612754
                SO-VID: b4ad05c8-485a-4414-89df-7f7822195bb0
                Copyright © Copyright © 2014 Chatterjee et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by Elsevier Ltd. All rights reserved.
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