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Background: Psychosocial interventions, crucial for recovery in patients with schizophrenia, have often been developed and tested in high income countries. We aimed at developing and validating home-based a booklet based psycho-social intervention with inputs from stakeholders: patients, families, and mental health professionals (MHP) for patients with schizophrenia and related disorders in low resource settings. Methods: We developed a preliminary version of psychosocial intervention booklets based on six themes derived from focus group discussions conducted with patients, families, and MHP. Initially, quantitative assessment of content validity was done by MHP on overall and Content Validity Index of individual items of the specific booklets, followed by in-depth interviews about their views. The booklets were modified based on their inputs. Further, pilot testing of manuals was done on the users - nine pairs of patients and caregivers followed by development of a final version of psycho-social intervention. Results: The percentage content validity of individual modules and overall booklets was ≥78.5% indicating good validity. Most MHP reported that the manuals were relevant and easy to use but were text-heavy, and lengthy. On pilot testing of modified manuals with patients and their family caregivers, majority (77.8%) of them found booklets useful and suggested that there should be separate booklets for both patients and caregivers for providing information and entering separate response for the activities, integrating helpful tips. Language should be simple. Finally, two sets of booklets (“info book” and “workbook”) named ‘Saksham’ (meaning empowered) were created with specific modules (viz., ‘Medicine adherence’, ‘Daily routine’, ‘Eating right’, ‘Physical activity’, ‘Physical health monitoring’, ‘Self-reliance’, and ‘Psychoeducation’) for patients and caregivers each, in two languages (Hindi and English). Conclusion: Booklets with modules for psychosocial interventions for patients with schizophrenia and their caregivers were developed after establishing content validity and pilot testing.

Background: Disordered eating behaviors (DEBs) among persons with schizophrenia (PwS) have been reported widely in the literature, with very few studies in India. Robust tools to assess DEB are needed in the vernacular language to capture symptoms of disordered eating accurately. No such tools are available in the Tamil language. Globally, the Eating Attitudes Test (EAT-26) is widely used to assess DEB among PwS. Aim: This study aimed to translate and study the factor structure and reliability of EAT-26 among Tamil-speaking PwS. Materials and Methods: EAT-26 was translated into Tamil following the Oxford linguistic validation process. Experts evaluated its face validity and content validity. One hundred and fifty PwS, aged between 18 and 65 years, who attended the outpatient department of a psychiatric facility, and consented to participate, completed the Tamil version of EAT-26. Test–retest reliability of EAT-26 was assessed by readministering the tool to 30 PwS after two weeks. Data were analyzed using Stata 16.1. Internal consistency and test–retest reliability were computed using Cronbach’s alpha and intraclass coefficients, respectively. The factor structure of EAT-26 was explored using principal component analysis (PCA). Spearman’s rho was calculated to understand the correlation between the factors. Results: EAT-26 had an internal consistency of 0.71 and test–retest reliability of 0.896. Factor analysis revealed nine latent factors consisting of 21 of the original 26 items on EAT-26. These 21 items could explain a variance of 63.63%. Conclusions: The Tamil version of the EAT-26 is a reliable tool to assess DEB among Tamil-speaking PwS. It can be used to screen PwS for eating disorder risk.

Background: We aimed to understand the needs of service users - families and patients with schizophrenia and related disorders, and mental health professionals (MHPs) and expectations from a home-based psychosocial intervention program in Indian setting., Materials and Methods: We conducted four focus group discussions (FGDs) with families, patients with schizophrenia and related disorders and MHPs. Two FGDs were conducted with families and one each with the patients and MHPs. Participants in families and MHP group were asked about their primary concerns in caring for the patients, perceived needs of patients and the areas that can be targeted through a home-based psychosocial intervention program. All FGDs were audio-recorded and verbatim transcribed. Content analysis of the data was done to obtain a final list of needs and expected outcomes from a psychosocial intervention supported by families., Results: Six key priority needs were identified for intervention: medication adherence, activities of daily living, promoting physical health, engagement in meaningful work, building of social and support networks and information about all aspects of illness. Priority outcomes identified by MHPs were mostly clinical like symptom reduction, fewer rehospitalisation while families and patients focused more on psychosocial outcomes, such as improvement of wellbeing, having relationships, engagement in meaningful activities, better organization of the day, increased self-respect, reduced stress, lesser interference, and critical comments. All groups suggested that book or mobile app or video could be used., Conclusion: This qualitative study shows that while both clinicians and service users consider recovery from schizophrenia and related disorders to be important, they differ on what they prioritise., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Journal of Psychiatry.)

This study describes the profile and nature of social disabilities in schizophrenia and the effect of intervention on them. Sixty five schizophrenic patients who constituted the experimental group were compared with sixty patients from a different centre. They were evaluated at intake for negative symptoms, social disabilities and psychological impairments. One group was provided with medication alone and the other was exposed to an intervention programme comprising of social skills training, family education, occupational therapy and medication management training, etc. After one year, both the groups were evaluated on the same parameters. It was found that both groups showed decline in some negative symptoms and improvement in certain disabilities. Issues such as duration of intervention, components of intervention and role of psychosocial rehabilitation are discussed.

Several instruments measuring social functioning have been developed in the last four decades, as a result of the increasing interest in community care of the chronic mentally ill. SCARF Social Functioning Index (SSFI) was developed to meet the pressing need for an instrument which was easy to administer and which could be used by all mental health professionals. The SSFI comprises four main sections: self concern, occupational role, role in the family and other social roles. Each section has several subsections covering different areas of social functioning. Validity and reliability have been established for a group of normals, patients suffering from schizophrenia and from Hansen's disease. Internal consistencies of these factors were high Factor analysis derived four main factors, which included nearly all items of the SSFI. This paper reports on the development and standardization of the instrument.

Sixty eight Feighner positive schizophrenic patients were followed up prospectively for a period of six years using standardized instruments. Disability was assessed in this sample using the Schedule for the Assessment of Psychiatric Disability at the end of 4, 5 and 6 years of follow up. It was found that the three year course of disability tended to be stable and fluctuations were minimal. Disability did not seem to be related to relapses. The implications of these findings in planning intervention programs for chronic schizophrenic patients are discussed.

59 Feighner positive Schizophrenics were assessed for subjective rehabilitation needs using a specially designed schedule for the purpose. It was observed that employment and vocational rehabilitation were most sought after, psychosocial rehabilitation less so, and accommodation hardly at all. Both women and men had identical needs, and the necessity for individualised package programmes was identified. The implications of the findings are discussed.

Forty couples who attended the Infertility clinic of Government Royapettah Hospital, Madras, were included in the study and compared with matched controls who had off springs. All 80 persons were administered the M.H.Q. and the E.P.I. Psychosocial data was recorded and a clinical psychiatric evaluation was done. 51 out of 80 in the study group had psychiatric problems, predominantly depression and anxiety. These problems increased with increasing duration of childless marriage. 40 % of the infertile group had psychosexual dysfunction such as premature ejaculation and erectile disturbances as opposed to 2.5% in the controls. Presence of vaginisms, dysmenorrhea and sexual dissatisfaction were more in the women of the study group. 15 males bad oligospermia/azospermia.

The life table has been used to study mortality and survival in a population and also the pattern of course of various chronic medical illnesses. In this study, the life table has been applied to a cohort of well defined Schizophrenic patients undergoing a long term followup. The probability of occurence of relapses, time of maximum risk for occurence of relapses are estimated using the life table technique. The life table shows a steep fall in the percentage of Non-relapsers from 85% at the end of first year to 35% at the end of the third year. Projected survival rate at the end of 5 years, using the second degree parabola curve, is only 2 % which needs to be tested by further followup.