Duration of Untreated Psychosis, Referral Route, and Age of Onset in an Early Intervention in Psychosis Service and a Local CAMHS

Abstract

Background: The aim of this study was to investigate associations between demographic and clinical variables and duration of untreated psychosis (DUP) in a sample of cases of psychosis across an adult early intervention in psychosis service and a child and adolescent community team. Method: Cross‐sectional baseline data for cases of psychosis across the two teams on the caseload at a given time point were collected, including age of onset, gender, ethnicity, referral route, and DUP. Results: The median DUP across the entire sample was 91 days, while those patients with initial treatment for psychosis from the child and adolescent team had a median DUP of 69 days. Using multiple linear regression, there were two variables that showed a significant association with DUP: referral route (p < .001), and age of onset, with earlier age of onset associated with shorter DUP (p = .015). Conclusion: These findings are discussed in relation to possible explanatory factors, with particular focus on service‐level variables and pathways to care. It is suggested that the involvement of child and adolescent teams is vital to the work of early intervention in psychosis services.

Effects of socio‐demographic characteristics, premorbid functioning, and insight on duration of untreated psychosis in first‐episode schizophrenia or schizophreniform disorder in Northern Malawi

“…Thus, early interventions to reduce DUP in this population must also focus on identifying and managing early psychosis in adolescents (Dominguez et al, 2013;Norman et al, 2004). However, another study found that younger age was associated with shorter DUP but proposed further investigations on this phenomenon (Kelso, Judith, Victoria, Mima, & Katherine, 2008 educated may lack understanding of the illness and may have ignorance toward the available service provisions (Basu, Subramaniam, Abdin, Poon, & Verma, 2015;Chee, Muhammad Dain, Abdul Aziz, & Abdullah, 2010;Lihong et al, 2012). This speculated difference in knowledge gap between the lower educated and the higher educated may implicitly emanate from the hypothesis that the higher educated could be well positioned than the lower educated in having access to information about the disease from various media sources (Tichenor, Donohue, & Olien, 1970).…”

Is early management of psychosis designed for migrants? Improving transcultural variable collection when measuring duration of untreated psychosis

“…Nine of these studies had included at least 1 of the following terms in their title, abstract or introduction: "demographic, socioenvironmental (…) predictors" (Broussard et al, 2013), "social determinants" (Nishii et al, 2010) or even "African-American (…) patients" (Compton, Esterberg, Druss, Walker, & Kaslow, 2006;Compton, Goulding, Gordon, Weiss, & Kaslow, 2009), "demographic characteristics" (O'Donoghue et al, 2014),"ethnicity" (Clarke et al, 2007;Cratsley, Regan, McAllister, Simic, & Aitchison, 2008),"socio-demographic contributors" (Chon et al, 2015) or "demographic factors" (Al Fayez, Lappin, Murray, & Boydell, 2017). Nonetheless, they did not explore transcultural variables after the introduction and were therefore excluded.…”

Psychosocial health and health‐related quality of life in school pupils 11–18 years

“…This suggests that there is a need for early identification of psychosocial problems and the provision of services which do not necessarily require a medical diagnosis to access. Cratsley et al (2008) report that even for young people with psychosis referral times depend on whether presentation is to A&E or by a home referral team. These referral pathways result in quicker referral than through mainstream referral to Child and Adolescent Mental Health Services (CAMHS).…”