Byron J. Good1, M. A. Subandi2, Carla Marchira2, Mary-Jo DelVecchio Good1; 1Harvard Medical School, 2Gadjah Mada University
From the beginning of our ethnographic and clinical research in 1996, the Yogyakarta team began identifying very rapid onset psychoses as unexpectedly common. This led to a series of studies investigating their cultural phenomenology, prevalence, the nature of prodromal features, and eventually to the relationship between acuteness of onset and long-term outcomes. Purpose: The overall aim of paper will be to present data about the nature and prevalence of acute onset illness among first episode first contact psychoses in Java, and to ask how the nature of onset relates to care-seeking and long-term course of illness. Methods: Data are drawn from ethnographic studies, an epidemiological study (of 304 first episode psychoses appearing for treatment in Yogyakarta in 6 months), an intensive set of 30 in-depth interviews with individuals and their care providers, and a 12 year follow-up of the 30 intensive cases. All data are retrospective studies of persons in first episode who have already contacted services. Findings: Our findings indicate that this is a real phenomenon, that as many as 36% of cases escalate from first appearance of psychotic symptoms to acute psychosis in a two week period, and that rapidity of seeking treatment is directly related to rapidity of onset. Small case studies indicate diversity in outcomes on follow-up. A 12 year follow-up of 30 intensive cases will be reported. Conclusion: Relevance of these studies for diagnostic issues, for studies of DUP and outcomes, and for the importance of cross-cultural research will be discussed.
