title: Psychiatric advance statements: an Indian experience.
abstract: BACKGROUND
  The psychiatric advance statement (PAS) is a document that outlines the preferences of patients in their future treatment. Formulating and writing a PAS has not been studied in low- and middle-income (LAMI) countries.
  
  
  OBJECTIVE
  To study the feasibility of writing a PAS in an Indian population.
  
  
  METHODS
  Patients' diagnosed with schizophrenia or schizoaffective psychosis attending the outpatient clinic at the Schizophrenia Research Foundation (SCARF) or its community centres in 2011 were screened using the study criteria. After obtaining informed consent, stratified sampling was used to derive the final sample.
  
  
  RESULTS
  Most patients consented to participate in the study (122/123 patients). Following interviews with research assistants, 93 patients were assessed to have the capacity to write a PAS and 92 completed one. The patients were mostly able to complete the PAS on their own. Major themes included choice of treatment facility, type of treatment and nomination of others to take decisions on their behalf. A third of the sample were either from rural areas or not exclusively urban. At the time of the study, about 45% of the sample was rated as being symptomatic.
  
  
  CONCLUSIONS
  Psychotic patients with a long-term illness, a third of them from non-urban areas, were able to write a valid PAS.
authors.affiliation: Schizophrenia Research Foundation, Chennai, India. rameshkumar@scarfindia.org
authors.forename: T C Ramesh
authors.initials: TC
authors.lastname: Kumar
authors.forename: Sujit
authors.initials: S
authors.lastname: John
authors.forename: Subhashini
authors.initials: S
authors.lastname: Gopal
authors.forename: Greeshma
authors.initials: G
authors.lastname: Mohan
authors.forename: Jainey
authors.initials: J
authors.lastname: Joseph
authors.forename: Thara
authors.initials: T
authors.lastname: Rangaswamy
mesh_terms: D000328:Adult; D016223:Advance Directives / Q000523:psychology* / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D055815:Young Adult