First episode psychosis and the trail to secondary care: help-seeking and health-system delays.
Saved in:
| Title: | First episode psychosis and the trail to secondary care: help-seeking and health-system delays. |
|---|---|
| Authors: | O'Callaghan, Eadbhard, Turner, Niall, Renwick, Laoise, Jackson, Deirdre, Sutton, Marie, Foley, Sharon D., McWilliams, Stephen, Behan, Caragh, Fetherstone, Alastair, Kinsella, Anthony |
| Source: | Social Psychiatry & Psychiatric Epidemiology. Mar2010, Vol. 45 Issue 3, p381-391. 11p. 7 Charts. |
| Subjects: | Psychoses, People with mental illness, Care of people, Mental health, Pathological psychology, Mental health services |
| Abstract: | People experience delays in receiving effective treatment for many illnesses including psychosis. These delays have adverse consequences in heart disease and cancer, and their causes have been the subject of much research but only in recent years have pathways to care in psychosis received such attention. We sought to establish if, when and where people seek help in the early phase of psychosis in a representative sample. One hundred and sixty-five people with first episode psychosis, referred from community-based psychiatric services and a private psychiatric facility to an early intervention service over 18 months, were interviewed with the Structured Clinical Interview for DSM-IV diagnoses. Symptoms were measured using the Schedule for the Assessment of Positive Symptoms, Schedule for the Assessment of Negative Symptoms and the Calgary Scale. Duration of untreated illness (DUI) and duration of untreated psychosis (DUP) were established using the Beiser Scale. Pathways to mental health services were systematically detailed through interviews with patients and their families. The final sample consisted of 142 (88M, 54F) cases after those with psychosis due to a general medical condition and those without pathway and DUP data were excluded. Less than half of participants initiated help seeking themselves. Of those who did seek help ( n = 57) 25% did so during the DUI. Those who had a positive family history of mental illness and poorer premorbid adjustment were significantly less likely to seek help for themselves and those who did not seek help were more likely to require hospitalisation. Families were involved in help seeking for 50% of cases and in 1/3 of cases did so without the affected individual participating in the contact. Being younger and having more negative symptoms were associated with having one’s family involved in help seeking. Delays to effective treatment from the onset of psychosis were evenly split between “help-seeking delays” and “health-system delays”. Having a family member involved in help seeking and better premorbid adjustment were independently associated with shorter help-seeking delays when measured from the onset of psychosis. Being female, having better premorbid adjustment and fewer negative symptoms were associated with shorter help-seeking delays from the onset of illness. Those with a non-affective psychosis had significantly longer system delays. Many people with first episode psychosis do not initiate help-seeking for themselves particularly those with a relative affected by mental illness. Those with poor premorbid adjustment are at particular risk of longer delays. Poor premorbid adjustment compounded by long delays to effective treatment reduces the likelihood of a good outcome. Families play a vital role in hastening receipt of effective treatment. [ABSTRACT FROM AUTHOR] |
| Copyright of Social Psychiatry & Psychiatric Epidemiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
|---|---|
| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 48219064 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: First episode psychosis and the trail to secondary care: help-seeking and health-system delays. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22O'Callaghan%2C+Eadbhard%22">O'Callaghan, Eadbhard</searchLink><br /><searchLink fieldCode="AR" term="%22Turner%2C+Niall%22">Turner, Niall</searchLink><br /><searchLink fieldCode="AR" term="%22Renwick%2C+Laoise%22">Renwick, Laoise</searchLink><br /><searchLink fieldCode="AR" term="%22Jackson%2C+Deirdre%22">Jackson, Deirdre</searchLink><br /><searchLink fieldCode="AR" term="%22Sutton%2C+Marie%22">Sutton, Marie</searchLink><br /><searchLink fieldCode="AR" term="%22Foley%2C+Sharon+D%2E%22">Foley, Sharon D.</searchLink><br /><searchLink fieldCode="AR" term="%22McWilliams%2C+Stephen%22">McWilliams, Stephen</searchLink><br /><searchLink fieldCode="AR" term="%22Behan%2C+Caragh%22">Behan, Caragh</searchLink><br /><searchLink fieldCode="AR" term="%22Fetherstone%2C+Alastair%22">Fetherstone, Alastair</searchLink><br /><searchLink fieldCode="AR" term="%22Kinsella%2C+Anthony%22">Kinsella, Anthony</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Social+Psychiatry+%26+Psychiatric+Epidemiology%22">Social Psychiatry & Psychiatric Epidemiology</searchLink>. Mar2010, Vol. 45 Issue 3, p381-391. 11p. 7 Charts. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Psychoses%22">Psychoses</searchLink><br /><searchLink fieldCode="DE" term="%22People+with+mental+illness%22">People with mental illness</searchLink><br /><searchLink fieldCode="DE" term="%22Care+of+people%22">Care of people</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+health%22">Mental health</searchLink><br /><searchLink fieldCode="DE" term="%22Pathological+psychology%22">Pathological psychology</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+health+services%22">Mental health services</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: People experience delays in receiving effective treatment for many illnesses including psychosis. These delays have adverse consequences in heart disease and cancer, and their causes have been the subject of much research but only in recent years have pathways to care in psychosis received such attention. We sought to establish if, when and where people seek help in the early phase of psychosis in a representative sample. One hundred and sixty-five people with first episode psychosis, referred from community-based psychiatric services and a private psychiatric facility to an early intervention service over 18 months, were interviewed with the Structured Clinical Interview for DSM-IV diagnoses. Symptoms were measured using the Schedule for the Assessment of Positive Symptoms, Schedule for the Assessment of Negative Symptoms and the Calgary Scale. Duration of untreated illness (DUI) and duration of untreated psychosis (DUP) were established using the Beiser Scale. Pathways to mental health services were systematically detailed through interviews with patients and their families. The final sample consisted of 142 (88M, 54F) cases after those with psychosis due to a general medical condition and those without pathway and DUP data were excluded. Less than half of participants initiated help seeking themselves. Of those who did seek help ( n = 57) 25% did so during the DUI. Those who had a positive family history of mental illness and poorer premorbid adjustment were significantly less likely to seek help for themselves and those who did not seek help were more likely to require hospitalisation. Families were involved in help seeking for 50% of cases and in 1/3 of cases did so without the affected individual participating in the contact. Being younger and having more negative symptoms were associated with having one’s family involved in help seeking. Delays to effective treatment from the onset of psychosis were evenly split between “help-seeking delays” and “health-system delays”. Having a family member involved in help seeking and better premorbid adjustment were independently associated with shorter help-seeking delays when measured from the onset of psychosis. Being female, having better premorbid adjustment and fewer negative symptoms were associated with shorter help-seeking delays from the onset of illness. Those with a non-affective psychosis had significantly longer system delays. Many people with first episode psychosis do not initiate help-seeking for themselves particularly those with a relative affected by mental illness. Those with poor premorbid adjustment are at particular risk of longer delays. Poor premorbid adjustment compounded by long delays to effective treatment reduces the likelihood of a good outcome. Families play a vital role in hastening receipt of effective treatment. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Social Psychiatry & Psychiatric Epidemiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=48219064 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00127-009-0081-x Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 11 StartPage: 381 Subjects: – SubjectFull: Psychoses Type: general – SubjectFull: People with mental illness Type: general – SubjectFull: Care of people Type: general – SubjectFull: Mental health Type: general – SubjectFull: Pathological psychology Type: general – SubjectFull: Mental health services Type: general Titles: – TitleFull: First episode psychosis and the trail to secondary care: help-seeking and health-system delays. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: O'Callaghan, Eadbhard – PersonEntity: Name: NameFull: Turner, Niall – PersonEntity: Name: NameFull: Renwick, Laoise – PersonEntity: Name: NameFull: Jackson, Deirdre – PersonEntity: Name: NameFull: Sutton, Marie – PersonEntity: Name: NameFull: Foley, Sharon D. – PersonEntity: Name: NameFull: McWilliams, Stephen – PersonEntity: Name: NameFull: Behan, Caragh – PersonEntity: Name: NameFull: Fetherstone, Alastair – PersonEntity: Name: NameFull: Kinsella, Anthony IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 03 Text: Mar2010 Type: published Y: 2010 Identifiers: – Type: issn-print Value: 09337954 Numbering: – Type: volume Value: 45 – Type: issue Value: 3 Titles: – TitleFull: Social Psychiatry & Psychiatric Epidemiology Type: main |
| ResultId | 1 |
