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Treatment delay and pathways to care in early psychosis.
Early Interv Psychiatry. 2014 Aug; 8(3):240-6.EI

Abstract

OBJECTIVE

To examine the treatment delay associated with community and inpatient pathways into care for persons experiencing a first episode of psychosis.

METHODS

A total of 104 clients entering a specialized early psychosis intervention (EPI) program and their family members were assessed for help-seeking behaviours, psychiatric symptoms, level of functioning and duration of untreated psychosis (DUP).

RESULTS

DUP (median = 30.5 weeks) was associated with younger age of onset, poorer engagement with the EPI program and more severe symptoms. Almost one-third of clients had four or more contacts before receiving antipsychotic medication or entering the EPI program and one in five received interventions not specifically indicated for psychosis. Referrals directly involving family members accounted for about 81% of hospital-initiated treatment (39% of all referrals) and 46% of community-initiated treatment (61% of all referrals). Community entry was associated with longer DUP, more time-seeking treatment, younger age of onset, younger age at referral, greater likelihood of receiving other medication or counselling before receiving antipsychotic medication, schizophrenia, less severe symptoms and less substance use in the previous year. Those with schizophrenia showed no differences across pathway type for time-seeking treatment, being provided interventions not specifically indicated for psychosis after onset or rates of substance use.

CONCLUSIONS

Treatment delay and the provision of interventions not specifically indicated for psychosis may be increased in first-episode populations who are younger and have less severe symptoms. Improving literacy about early psychosis in both professionals and families merits greater attention.

Authors+Show Affiliations

Early Psychosis Intervention Program, c/o Peace Arch Hospital, White Rock, British Columbia, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23682935

Citation

Ehmann, Tom S., et al. "Treatment Delay and Pathways to Care in Early Psychosis." Early Intervention in Psychiatry, vol. 8, no. 3, 2014, pp. 240-6.
Ehmann TS, Tee KA, MacEwan GW, et al. Treatment delay and pathways to care in early psychosis. Early Interv Psychiatry. 2014;8(3):240-6.
Ehmann, T. S., Tee, K. A., MacEwan, G. W., Dalzell, K. L., Hanson, L. A., Smith, G. N., Kopala, L. C., & Honer, W. G. (2014). Treatment delay and pathways to care in early psychosis. Early Intervention in Psychiatry, 8(3), 240-6. https://doi.org/10.1111/eip.12051
Ehmann TS, et al. Treatment Delay and Pathways to Care in Early Psychosis. Early Interv Psychiatry. 2014;8(3):240-6. PubMed PMID: 23682935.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment delay and pathways to care in early psychosis. AU - Ehmann,Tom S, AU - Tee,Karen A, AU - MacEwan,G W, AU - Dalzell,Kacey L, AU - Hanson,Laura A, AU - Smith,Geoff N, AU - Kopala,Lili C, AU - Honer,William G, Y1 - 2013/05/20/ PY - 2012/09/29/received PY - 2013/03/23/accepted PY - 2013/5/21/entrez PY - 2013/5/21/pubmed PY - 2015/4/17/medline KW - duration of untreated psychosis KW - pathways to psychiatric care KW - psychosis KW - schizophrenia KW - service delivery SP - 240 EP - 6 JF - Early intervention in psychiatry JO - Early Interv Psychiatry VL - 8 IS - 3 N2 - OBJECTIVE: To examine the treatment delay associated with community and inpatient pathways into care for persons experiencing a first episode of psychosis. METHODS: A total of 104 clients entering a specialized early psychosis intervention (EPI) program and their family members were assessed for help-seeking behaviours, psychiatric symptoms, level of functioning and duration of untreated psychosis (DUP). RESULTS: DUP (median = 30.5 weeks) was associated with younger age of onset, poorer engagement with the EPI program and more severe symptoms. Almost one-third of clients had four or more contacts before receiving antipsychotic medication or entering the EPI program and one in five received interventions not specifically indicated for psychosis. Referrals directly involving family members accounted for about 81% of hospital-initiated treatment (39% of all referrals) and 46% of community-initiated treatment (61% of all referrals). Community entry was associated with longer DUP, more time-seeking treatment, younger age of onset, younger age at referral, greater likelihood of receiving other medication or counselling before receiving antipsychotic medication, schizophrenia, less severe symptoms and less substance use in the previous year. Those with schizophrenia showed no differences across pathway type for time-seeking treatment, being provided interventions not specifically indicated for psychosis after onset or rates of substance use. CONCLUSIONS: Treatment delay and the provision of interventions not specifically indicated for psychosis may be increased in first-episode populations who are younger and have less severe symptoms. Improving literacy about early psychosis in both professionals and families merits greater attention. SN - 1751-7893 UR - https://www.unboundmedicine.com/medline/citation/23682935/Treatment_delay_and_pathways_to_care_in_early_psychosis_ L2 - https://doi.org/10.1111/eip.12051 DB - PRIME DP - Unbound Medicine ER -