Reducing duration of untreated psychosis: care pathways to early intervention in psychosis services

被引:130
作者
Birchwood, Max [1 ,2 ]
Connor, Charlotte [3 ,4 ]
Lester, Helen [5 ]
Patterson, Paul [4 ,6 ]
Freemantle, Nick [7 ]
Marshall, Max [8 ]
Fowler, David [9 ]
Lewis, Shon [8 ]
Jones, Peter [10 ]
Amos, Tim [11 ]
Everard, Linda [12 ]
Singh, Swaran P. [13 ]
机构
[1] Univ Birmingham, Sch Psychol, Birmingham B15 2TT, W Midlands, England
[2] Birmingham & Solihull Mental Hlth Fdn Trust, YouthSpace Mental Hlth Serv, Birmingham, W Midlands, England
[3] CLAHRC Birmingham & Solihull Mental Hlth Fdn Trus, Birmingham, W Midlands, England
[4] Univ Birmingham, Birmingham B15 2TT, W Midlands, England
[5] Univ Birmingham, Sch Hlth & Populat Sci, Birmingham B15 2TT, W Midlands, England
[6] Birmingham & Solihull Mental Hlth Fdn Trust, YouthSpace, Birmingham, W Midlands, England
[7] UCL Med Sch, Dept Primary Care & Populat Hlth, London, England
[8] Univ Manchester, Manchester M13 9PL, Lancs, England
[9] Univ E Anglia, Fac Med & Hlth Sci, Norwich NR4 7TJ, Norfolk, England
[10] Univ Cambridge, Dept Psychiat, Cambridge, England
[11] Acad Unit Psychiat, Bristol, Avon, England
[12] Birmingham & Solihull Mental Hlth Fdn Trust, Birmingham, W Midlands, England
[13] Univ Warwick, Coventry CV4 7AL, W Midlands, England
基金
美国国家卫生研究院;
关键词
FIRST-EPISODE; 1ST-EPISODE PSYCHOSIS; YOUNG-PEOPLE; SCHIZOPHRENIA; PANSS;
D O I
10.1192/bjp.bp.112.125500
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Background Interventions to reduce treatment delay in first-episode psychosis have met with mixed results. Systematic reviews highlight the need for greater understanding of delays within the care pathway if successful strategies are to be developed. Aims To document the care-pathway components of duration of untreated psychosis (DUP) and their link with delays in accessing specialised early intervention services (EIS). To model the likely impact on efforts to reduce DUP of targeted changes in the care pathway. Method Data for 343 individuals from the Birmingham, UK, lead site of the National EDEN cohort study were analysed. Results A third of the cohort had a DUP exceeding 6 months. The greatest contribution to DUP for the whole cohort came from delays within mental health services, followed by help-seeking delays. It was found that delay in reaching EIS was strongly correlated with longer DUP. Conclusions Community education and awareness campaigns to reduce DUP may be constrained by later delays within mental health services, especially access to EIS. Our methodology, based on analysis of care pathways, will have international application when devising strategies to reduce DUP.
引用
收藏
页码:58 / 64
页数:7
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