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Association of treatment delay, migration and urbanicity in psychosis

Published online by Cambridge University Press:  15 April 2020

N. Boonstra*
Affiliation:
Friesland Mental Health Care Service, Department of Education and Research, PO Box 932, 8901Leeuwarden, The Netherlands Academic Medical Center, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, Room PA3-129, 1105AZ Amsterdam, The Netherlands NHL University of Applied Science, Institute of Healthcare and Welfare Studies, Leeuwarden, The Netherlands
B. Sterk
Affiliation:
Academic Medical Center, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, Room PA3-129, 1105AZ Amsterdam, The Netherlands
L. Wunderink
Affiliation:
Friesland Mental Health Care Service, Department of Education and Research, PO Box 932, 8901Leeuwarden, The Netherlands
S. Sytema
Affiliation:
Department of psychiatry (CC72), University Center of Psychiatry, University Medical Centre Groningen, University Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
L. De Haan
Affiliation:
Academic Medical Center, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, Room PA3-129, 1105AZ Amsterdam, The Netherlands
D. Wiersma
Affiliation:
Department of psychiatry (CC72), University Center of Psychiatry, University Medical Centre Groningen, University Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
*
*Corresponding author. Tel.: +3158 284 8989; fax: +3158 284 8040. E-mail address:[email protected] (N. Boonstra).
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Abstract

Background

Several factors may contribute to duration of untreated psychosis (DUP): patient-delay, referral-delay and treatment-delay caused by mental health care services (MHS-delay). In order to find the most effective interventions to reduce DUP, it is important to know what factors in these pathways to care contribute to DUP.

Aim

To examine the relationship of the constituents of treatment delay, migration status and urbanicity.

Method

In first episode psychotic patients (n = 182) from rural, urban and highly urbanized areas, DUP, migration status and pathways to care were determined.

Results

Mean DUP was 53.6 weeks (median 8.9, SD=116.8). Patient-delay was significantly longer for patients from highly urbanized areas and for first generation immigrants. MHS-delay was longer for patients who were treated already by MHS for other diagnoses.

Conclusions

Specific interventions are needed focusing on patients living in highly urbanized areas and first generation immigrants in order to shorten patient delay. MHS should improve early detection of psychosis in patients already in treatment for other diagnosis.

Type
Original articles
Copyright
Copyright © European Psychiatric Association 2012

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Footnotes

1

These two authors contributed equally to this work and are joined first authors.

References

Addington, J.Van Mastrigt, S.Hutchinson, J.Addington, D.Pathways to care: help seeking behaviour in first episode psychosis. Acta Psychiatr Scand. 2002; 106(5): 358364.CrossRefGoogle ScholarPubMed
Anderson, KK, Fuhrer, R, Malla, AKThe pathways to mental health care of first-episode psychosis patients: a systematic review. Psychol Med 2010;113.Google ScholarPubMed
Andreasen, N.C.Flaum, M.Arndt, S.The Comprehensive Assessment of Symptoms and History (CASH). An instrument for assessing diagnosis and psychopathology. Arch Gen Psychiatry. 1992; 49(8): 615623.CrossRefGoogle ScholarPubMed
Bechard-Evans, L.Schmitz, N.Abadi, S.Joober, R.King, S.Malla, A.Determinants of help-seeking and system related components of delay in the treatment of first-episode psychosis. Schizophr Res. 96 1–3: 2007 206214.CrossRefGoogle ScholarPubMed
Boonstra, N.Wunderink, L.Sytema, S.Wiersma, D.Improving detection of first-episode psychosis by mental health-care services using a self-report questionnaire. Early Interv Psychiatry. 2009; 3: 280296.CrossRefGoogle ScholarPubMed
Brunet, K.Birchwood, M.Lester, H.Thornhill, K.Delays in mental health services and duration of untreated psychosis. Psychiatr Bull. 2007; 31: 408410.CrossRefGoogle Scholar
Compton, M.T.Barriers to initial outpatient treatment engagement following first hospitalization for a first episode of non affective psychosis: a descriptive case series. J Psychiatr Pract. 2005; 11(1): 6269.CrossRefGoogle Scholar
Compton, M.T.Chien, V.H.Leiner, A.S.Goulding, S.M.Weiss, P.S.Mode of onset of psychosis and family involvement in help-seeking as determinants of duration of untreated psychosis. Soc Psychiatry Psychiatr Epidemiol. 2008; 43(12): 975982.CrossRefGoogle ScholarPubMed
Harrison, G.Holton, A.Neilson, D.Owens, D.Boot, D.Cooper, J.Severe mental disorder in Afro-Caribbean patients: some social, demographic and service factors. Psychol Med. 1989; 19(3): 683696.CrossRefGoogle ScholarPubMed
Marshall, M.Lewis, S.Lockwood, A.Drake, R.Jones, P.Croudace, T.Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Arch Gen Psychiatry. 2005; 62(9): 975983.CrossRefGoogle ScholarPubMed
Morgan, C.Abdul-Al, R.Lappin, J.M.Jones, P.Fearon, P.Leese, M.et al.Clinical and social determinants of duration of untreated psychosis in the AESOP first-episode psychosis study. Br J Psychiatry. 2006; 189: 446452.CrossRefGoogle ScholarPubMed
Morgan, C.Fearon, P.Hutchinson, G.McKenzie, K.Lappin, J.M.Abdul-Al, R.et al.Duration of untreated psychosis and ethnicity in the AESOP first-onset psychosis study. Psychol Med. 2006; 36(2): 239247.CrossRefGoogle ScholarPubMed
Morgan, C.Mallett, R.Hutchinson, G.Bagalkote, H.Morgan, K.Fearon, P.et al.Pathways to care and ethnicity. 2: source of referral and help-seeking. Report from the AESOP study. Br J Psychiatry. 2005; 186: 290296.CrossRefGoogle ScholarPubMed
Nelson, B.Yung, A.R.When things are not as they seem: detecting first-episode psychosis upon referral to ultra high risk (prodromal) clinics. Early Interv Psychiatry. 2007; 1: 208211.CrossRefGoogle Scholar
Nienhuis, F.J.van de, W.G.Rijnders, C.A.de Jonge, P.Wiersma, D.Validity of a short clinical interview for psychiatric diagnosis: the mini-SCAN. Br J Psychiatry. 2010; 196(1): 6468.CrossRefGoogle Scholar
Nishii, H.Yamazawa, R.Shimodera, S.Suzuki, M.Hasegawa, T.Mizuno, M.Clinical and social determinants of a longer duration of untreated psychosis of schizophrenia in a Japanese population. Early Interv Psychiatry. 2010; 4(2): 182188.CrossRefGoogle Scholar
Norman, R.M.Lewis, S.W.Marshall, M.Duration of untreated psychosis and its relationship to clinical outcome. Br J Psychiatry Suppl. 2005; 48: s19s23.CrossRefGoogle ScholarPubMed
Norman, R.M.Malla, A.K.Verdi, M.B.Hassall, L.D.Fazekas, C.Understanding delay in treatment for first-episode psychosis. Psychol Med. 2004; 34(2): 255266.CrossRefGoogle ScholarPubMed
Perkins, D.O.Gu, H.Boteva, K.Lieberman, J.A.Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis. Am J Psychiatry. 2005; 162(10): 17851804.CrossRefGoogle ScholarPubMed
Rietdijk, J.Dragt, S.Klaassen, R.Ising, H.Nieman, D.Wunderink, L.et al.A single blind randomized controlled trial of cognitive behavioural therapy in a help-seeking population with an at risk mental state for psychosis: the dutch early detection and intervention evaluation (EDIE-NL) trial. Trials. 2010; 11: 30.CrossRefGoogle Scholar
Selten, J.P.Veen, N.Feller, W.Blom, J.D.Schols, D.Camoenie, W.et al.Incidence of psychotic disorders in immigrant groups to The Netherlands. Br J Psychiatry. 2001; 178: 367372.CrossRefGoogle ScholarPubMed
Singh, S.P.Outcome measures in early psychosis; relevance of duration of untreated psychosis. Br J Psychiatry Suppl. 2007; 50: s58s63.CrossRefGoogle ScholarPubMed
Singh, S.P.Cooper, J.E.Fisher, H.L.Tarrant, C.J.Lloyd, T.Banjo, J.et al.Determining the chronology and components of psychosis onset: the Nottingham Onset Schedule (NOS). Schizophr Res. 2005; 80(1): 117130.CrossRefGoogle ScholarPubMed
Singh, S.P.Grange, T.Measuring pathways to care in first-episode psychosis: a systematic review. Schizophr Res. 2006; 81(1): 7582.CrossRefGoogle ScholarPubMed
Snowden, L.R.Yamada, A.M.Cultural differences in access to care. Annu Rev Clin Psychol. 2005; 1: 143166.CrossRefGoogle ScholarPubMed
Wolff, G.Pathare, S.Craig, T.Leff, J.Community knowledge of mental illness and reaction to mentally ill people. Br J Psychiatry. 1996; 168(2): 191198.CrossRefGoogle ScholarPubMed
Wunderink, L.Nienhuis, F.J.Sytema, S.Wiersma, D.Predictive validity of proposed remission criteria in first-episode schizophrenic patients responding to antipsychotics. Schizophr Bull. 2007; 33(3): 792796.CrossRefGoogle ScholarPubMed
Yamazawa, R.Mizuno, M.Nemoto, T.Miura, Y.Murakami, M.Kashima, H.Duration of untreated psychosis and pathways to psychiatric services in first-episode schizophrenia. Psychiatr Clin Neurosci. 2004; 58(1): 7681.CrossRefGoogle ScholarPubMed
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