ABSTRACT
INTRODUCTION: As mental health systems are still developing in many Asian countries, knowledge of the pathways to mental health care (MHC) in this region would be very important. AIMS: To clarify the pathways to MHC in 5 Asian countries. METHOD: A total of 50 new subjects attending each institution were interviewed. Pathway diagrams, the patterns and duration of care seeking, and the previous treatment were compared. RESULTS: Four major pathways were direct access, referrals from private practitioners, referrals from general hospitals, and referrals from native or religious healers. General practitioners did not play a pivotal role in any of the areas, whereas native or religious healers had an important place in all areas except for Yokohama, Japan. Family members had a significant impact on the decision to seek MHC. CONCLUSIONS: Studies of pathways to MHC in Asian countries are feasible and can provide data of interest in the organization of care.
Subject(s)
Mental Health Services/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Adult , Asia , Family , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Referral and Consultation , Socioeconomic FactorsABSTRACT
BACKGROUND: Delusional Parasitosis (DP) is a relatively uncommon condition wherein there is a fixed belief that one is infested with living organisms despite a lack of medical evidence of such infestation. Pimozide has been mooted as specific for the treatment of this condition. Atypical anti-psychotics have received attention in recent years. METHODS: We describe the clinical features and treatment responses in a retrospective review of 20 cases treated at this department over a 5 year period, and selectively review the literature. RESULTS: The majority were treated with atypical anti-psychotics and all subjects who followed up showed varying degrees of clinical improvement irrespective of the anti-psychotic used. CONCLUSION: The evidence for pimozide as first line drug in DP is limited to one small, non-randomized placebo-controlled trial. DP responds well to most anti-psychotics. Prospective randomized trials are needed to clarify optimal treatment of this relatively rare but debilitating condition.
