Detection and characteristics of individuals with a very long duration of untreated psychosis in an early intervention for psychosis service
Abstract
Aim: Early intervention (EI) services for psychosis aim to reduce the duration of untreated psychosis (DUP) with intensive large‐scale multi‐focus initiatives, including public awareness campaigns. As a consequence of this approach, individuals with a very long DUP who might have otherwise remained undiagnosed may come to medical attention. The aim of this study was to investigate if an EI service detected additional cases of individuals with a first‐episode psychosis (FEP) with a very long DUP and identify demographic and clinical characteristics associated with a very long DUP. Methods: We compared the distribution of the DUP in cases with FEP in a cohort from an EI service in a geographically defined catchment area with a historical control group. Participants were interviewed using the S tructured C linical I nterview for DSM IV (D iagnostic and S tatistical M anual of M ental D isorders, F ifth E dition) diagnoses and the Beiser scale to determine the DUP. Results: A total of 172 individuals were included in the EI service and 151 were included from the historical control. There was no difference in the distribution of the DUP in the EI service compared with the historical control group (χ 2 = 3.77, degrees of freedom (d.f.) = 3, P = 0.29). In the EI service, 7.6% of cases had a DUP between 24 and 35.9 months compared to 3.3% in the historical control, and 13.4% of cases in the EI service had a DUP of greater than three years compared to 10.6% in the historical control. A very long DUP was associated with unemployment, less insight and involuntary treatment. Conclusion: Further examination of the pathways to care in cases with a long DUP may clarify the contribution of help‐seeking and health system delays for these individuals.
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The relationship between insight and non-adherence may occur early in the illness.
“The relationship between insight and non-adherence may also occur early in the illness, as suggested by studies linking poor insight to a longer duration of untreated psychosis 24,25 .”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [25]
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Lysaker, P. H., Pattison, M. L., Leonhardt, B. L., Phelps, S., & Vohs, J. L. (2018) · World Psychiatry · doi:10.1002/wps.20508 · Cited by 247 · see citing works
- Authors
- O'Donoghue, B., Lyne, J., Kinsella, A., Turner, N., O'Callaghan, E., & Clarke, M.
- Affiliations
- DETECT, Early Intervention in Psychosis Service Dublin Ireland
- Corresponding author
- O'Donoghue, Brian
- Venue
- Early Intervention in Psychiatry
- Publisher
- Wiley
- Published
- 2013-06-20
- Volume
- 8
- Issue
- 4
- Pages
- 332-339
- ISSN
- 1751-7885 (ISSN-L)
- 1751-7893
- OpenAlex
- W1538103911
- Cited by
- 16
- References
- 25
- Citations by year
- 2021: 2 · 2020: 1 · 2019: 3 · 2018: 6 · 2017: 2 · 2014: 1 · 2013: 1
- FWCI
- 0.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Early Intervention in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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
- duration of untreated psychosis, first-episode psychosis, early intervention in psychosis, underdiagnosis, help-seeking, pathways to care, unemployment, insight, involuntary treatment, historical control groups
- MeSH terms
- Adult, Female, Health Education, Humans, Mental Health Services, Psychotic Disorders, Time Factors, Program Evaluation, Early Diagnosis, Young Adult, Early Medical Intervention
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