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Ethno-psychopharmacological aspects of treatment response in patients with delusional syndrome: A systematic review

Published online by Cambridge University Press:  13 August 2021

A. Guàrdia ,
A. González-Rodríguez ,
M.V. Seeman ,
A. Alvarez Pedrero ,
M. Betriu ,
J.A. Monreal ,
D. Palao Vidal  and
J. Labad
A. Guàrdia*
Affiliation:
Mental Health, Parc Taulí University Hospital. Autonomous University of Barcelona (UAB). I3PT, Sabadell, Spain
A. González-Rodríguez
Affiliation:
Mental Health, Parc Taulí-University Hospital, Sabadell, Spain
M.V. Seeman
Affiliation:
Psychiatry, University of Toronto, Toronto, Canada
A. Alvarez Pedrero
Affiliation:
Mental Health, Parc Taulí University Hospital. Autonomous University of Barcelona (UAB). I3PT, Sabadell, Spain
M. Betriu
Affiliation:
Mental Health, Parc Taulí University Hospital. Autonomous University of Barcelona (UAB). I3PT, Sabadell, Spain
J.A. Monreal
Affiliation:
Mental Health, Parc Taulí University Hospital. Autonomous University of Barcelona (UAB). I3PT, Sabadell, Spain
D. Palao Vidal
Affiliation:
Mental Health, Parc Tauli-University Hospital, Sabadell (Barcelona), Spain
J. Labad
Affiliation:
Mental Health, Hospital of Mataró. Consorci Sanitari del Maresme. CIBERSAM., Mataró, Spain
*
*Corresponding author.

Abstract

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Introduction

Treatment response in schizophrenia can be influenced by cultural and ethno-biological factors. However, in delusional disorder (DD), these potential influences have been poorly investigated.

Objectives

This review aims to synthesize what is known about the influence that cultural and biological factors may have on treatment response in DD.

Methods

A systematic review was performed on PubMed from inception to 2020 in keeping with PRISMA directives. Search terms: [(cultural OR ethnic* OR ethno*) AND (treatment OR therap* OR antipsychotic response) AND (delusional disorder)]. We included all studies whose objective was to explore ethno-psychopharmacological aspects of treatment response in DD.

Results

A total of 182 papers were retrieved. Four studies tested ethno-biological factors and 10 reported cultural aspects of treatment response in DD. 1. Cultural hypothesis: 3 studies reported cultural differences in diagnostic practices; in 2 studies, culturally-determined long durations of untreated psychosis (DUP) and comorbidity with mood disorders was associated with response to both antipsychotics (AP) and antidepressants (AD); 3 studies reported that response and AP dose were similar among cultures and that culturally-sensitive psychotherapy improved adherence; 2 studies showed that, where women had poor access to health care, mortality rates were high. 2. Ethno-biological hypothesis: 1 study reviewed moderators and mediators of ethno-specific treatment response; 1 study presented a culture-bound syndrome (Taijin kyofusho) for which AD were found effective; 2 studies in diverse populations found that DD and schizophrenia were both significantly linked to HLA genes.

Conclusions

The sociodemographic profile of DD is consistent across various cultures and, when treated appropriately, responds, but in an ethno-culturally-specific manner.

Disclosure

No significant relationships.

Keywords

Delusional disordercultural and ethno-biological factors.potential influencestreatment response
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S158 - S159
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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