Pathways to psychosis: Help-seeking behavior in the prodromal phase
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Background Knowledge of pathways to care by help-seeking patients prior to the onset of psychosis may help to improve the identification of at-risk patients. This study explored the history of help-seeking behavior in secondary mental health care services prior to the onset of the first episode of psychosis. Method The psychiatric case register in The Hague was used to identify a cohort of 1753 people in the age range of 18-35 at first contact who developed a psychotic disorder in the period from 1 January 2005 to 31 December 2009. We retrospectively examined the diagnoses made at first contact with psychiatric services. Results 985 patients (56.2%) had been treated in secondary mental health services prior to the onset of psychosis. The most common disorders were mood and anxiety disorders (N=385 (39.1%)) and substance use disorders (N=211 (21.4%)). Affective psychoses were more often preceded by mood/anxiety disorders, while psychotic disorder NOS was more often preceded by personality disorder or substance abuse. The interval between first contact and first diagnosis of psychosis was approximately 69 months in cases presenting with mood and anxiety disorders and 127 months in cases presenting with personality disorders. Discussion This study confirms the hypothesis that the majority of patients with psychotic disorders had been help-seeking for other mental disorders in the secondary mental health care prior to the onset of psychosis.
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The findings related to those with anxiety disorders are relatively unique, given the limited literature on the presentation of paranoia and prodromal symptoms in anxiety disorder populations.
“However, the findings related to those with anxiety disorders are relatively unique, given the limited literature on the presentation of paranoia (Reich & Braginsky, 1994; Taylor & Stopa, 2013) and prodromal symptoms (Rietdijk et al., 2011; Shioiri et al., 2007) in anxiety disorder populations.”
From Intolerance of uncertainty, paranoia, and prodromal symptoms: Comparisons between a schizophrenia spectrum disorder, anxiety disorder and non‐clinical sample. (2025) · cites this paper as Rietdijk et al., 2011
Section 4.1 reports that anxiety and mood disorders were the most common prior diagnoses among patients who later developed psychosis, making this paper relevant to the cited topic. But the study starts with a psychosis cohort and examines its earlier diagnoses; it does not study prodromal-symptom presentation in a population selected for anxiety disorders. The sentence’s characterization of the literature as limited is the citing authors’ framing, not a finding established by this source. (LLM, conf=0.81)
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Health literacy in clinical‐high‐risk individuals for psychosis: A systematic mixed‐methods review
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Medical and Psychiatric Care Preceding the First Psychotic Disorder Diagnosis
Benson, N. M., Yang, Z., Fung, V., Normand, S. T., Keshavan, M. S., Öngür, D., & Hsu, J. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad125 · Cited by 6 · see citing works
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Factors impacting intent to seek treatment within youth at clinical high risk for psychosis
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Psychotic Disorders and Substance Use Disorders
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Psychotic Disorders and Substance Use Disorders
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Mental health antecedents in first episode of psychosis: impact on prognosis across transitional age
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- Authors
- Rietdijk, J., Hogerzeil, S. J., van Hemert, A. M., Cuijpers, P., Linszen, D. H., & van der Gaag, M.
- Affiliations
- Parnassia Groep (NL)
- Amsterdam Public Health (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Rietdijk, Judith
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2011-11
- Volume
- 132
- Issue
- 2-3
- Pages
- 213-219
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W2136048719
- Cited by
- 64
- References
- 42
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 3 · 2023: 5 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 1 · 2017: 3 · 2016: 7 · 2015: 7 · 2014: 5 · 2013: 4 · 2012: 6
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Funders
- The Netherlands Health Research Council (120510001, NTR1085)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- help-seeking, prodromal symptoms
- MeSH terms
- Delivery of Health Care, Female, Humans, Male, Psychiatric Status Rating Scales, Psychotic Disorders
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