Abstract
Background: Most of our knowledge about the etiology, course, treatment, and outcome of schizophrenia spectrum and other psychotic disorders stems from Western countries. Data from populations living in other geographical areas and low- and middle-income countries, with different genomes (ethnicity) and exposomes (e.g., culture and social support, drugs of abuse, religion), will add to our knowledge of this complex disorder.Methods: The Azeri Acute phase/Recent onset psychosis Survey (ARAS) has been initiated to study the course of the disorder in patients with recent-onset psychosis using validated diagnostic tools and a comprehensive outcome monitoring system, aiming to reveal indicators for understanding the risk and resilience factors and for choosing the best-personalized treatment strategy. All participants will be evaluated for clinical signs and symptoms as well as risk and resilience factors and will be followed up for 1, 3, and 5 years for outcomes in several domains. A hierarchical cluster method will be applied to identify the number of clusters for each outcome. Defined models will be applied to assess the predictive value of cognition on symptomatic and functional outcomes at follow-up.Discussion: The ARAS cohort will yield significant academic- (research and education) and care-related achievements. ARAS data and experience will have value both in being a useful model for other parts of this region and in an expansion of the currently available knowledge.
Highlights
Most of our knowledge about the etiology, course, treatment, and outcome of schizophrenia spectrum and other psychotic disorders stems from Western countries
Older studies suggested that the course of psychotic disorders may be more favorable in lowand middle-income countries (LMIC) (WHO 10 country study), while other studies point at a large treatment gap as a cause of poor outcome in LMIC [10]
We considered five types of outcomes: [1] dimension of psychosis [58], [2] cognitive functioning [58], [3] symptom remission [59], [4] diagnostic stability [60], and [5] functional remission [61]
Summary
Most of our knowledge about the etiology, course, treatment, and outcome of schizophrenia spectrum and other psychotic disorders stems from Western countries. Schizophrenia, as the prototype of the schizophrenia spectrum (SSD) and other psychotic disorders [1], remains one of the most costly disorders in terms of human suffering and societal expenditure [2, 3]. It contributed 1.7% of total years of life lived with disability (YLDs) to the global burden of disease in 2016. Socio-cultural differences such as social support, religious and cultural beliefs, and differences in mental health care organization might explain a substantial portion of these epidemiological variations [11]
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