Prevalence, service use and clinical correlates of hallucinations and delusions in an out-patient population from India

Abstract

Background

Despite the persistent public health problem of positive psychotic symptoms, understanding of symptom specific prevalence rates, clinical correlates and service utilisation are sparse.

Aims

The current study aimed to establish prevalence, clinical and service utilisation correlates of hallucinations and delusions in people accessing outpatient clinics in Tamil Nadu, India.

Methods

Secondary patient data from outpatient clinics, over a 12-month period, in 2016, was used for analysis (N = 917). Based on the presence of positive psychotic symptoms (PPSx), the sample was divided into four groups for analysis- hallucinations-only (H), delusions-only (D), both hallucinations and delusions (HD) and neither PPSx (N-PPSx).

Results

Findings indicate that the most prevalent PPSx were hallucinations (10.7%) however, barriers to service utilisation and clinical correlates were associated predominantly with the D and the HD group; as was severe work impairment. Yet, this group was most likely to remain with psychiatric services. Lastly, diagnostic challenges were apparent within the sample.

Conclusions

The study revealed that despite more barriers to service utilisation, persons with PPSx remain in contact with services. Yet prognosis remains only moderate at best, indicating other mediating and underlying factors impeding recovery may be interplaying and, therefore, a need for enhanced biopsychosocial approaches.

Keywords:

• Positive psychotic symptoms
• India
• LMICs
• service use
• diagnostic challenges

Ethics statement

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. All procedures involving human subjects/patients were approved by the Internal Research Review Board at The Banyan.

Consent statement

Secondary, de-identified data was used for the purposes of this study. Participants provided consent at the time of clinic registration that their information may be stored electronically and utilized for research purposes within the organisation.

Author details

SMRITI VALLATH, PhD, Lead Center for Trauma studies and innovation, and Faculty, Department of Applied Psychology and Social Work in Mental Health, The Banyan Academy of Leadership in Mental Health, India; Psychologist, Department of Clinical Psychology. The Banyan, India. Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Science, VU University Amsterdam, Amsterdam, The Netherlands; LAKSHMI NARASIMHAN, PhD, The Banyan, Chennai, India; PRIYANKA M, MSc, The Banyan, Chennai, India; VISHNU VARADARAJAN, BS, Washington University in St. Louis, Missouri, US; LAKSHMI RAVIKANTH, PhD, Department of Applied Psychology The Banyan Academy of Leadership in Mental Health (BALM), Chennai, India.

Acknowledgements

The authors would like to thank the monitoring and evaluation team of the organisation of study for their time and patience in providing the research team with available data. The authors would also like to thank their colleagues from the clinical team who have been invaluable in documenting data during practice and offering clarity in the event of missing data.

Disclosure statement

The authors declare that there is no conflict of interest with regards to this study.

Author contributions

SV, LN and PM had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: SV

Acquisition, analysis, or interpretation of data: PM, LN, SV

Drafting of Manuscript: SV

Critical revision of the manuscript for important intellectual content: SV

Statistical Analysis: LN, SV

Administrative, technical, or material support: Authors institutions

Study support: LN, LR

Research Assistant: VV

Data availability statement

Data is available in The Banyan data warehouse. The authors had full access to de-identified data related to the study and will have continued access to the database used in this study