Duration of untreated psychotic illness

Peralta, Víctor; Cuesta, Manuel J.; Martínez-Larrea, Alfredo; Serrano, Jose F.; Langarica, M.

doi:10.1007/s00127-005-0905-2

Cited by 29 publications

(3 citation statements)

References 21 publications

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“…Our study therefore supports individual- and familial-based initiatives to reduce the duration of untreated psychosis in the community, such as the provision of early intervention in psychosis services, which aim to improve the long-term outcomes of severe mental illness by providing early treatment and care to people with psychosis (Department of Health, 2001; Lester et al, 2009) It is, however, noteworthy that important clinical and social inequalities in DUP (Morgan et al, 2006a), and pathways to care (Morgan et al, 2005a, 2005b), remain for some groups. There is also some evidence that poor social support may lengthen the duration of untreated psychosis (Peralta et al, 2005), which overlaps with our previous finding that family involvement is also important in reducing DUP (Morgan et al, 2006a). One previous study has shown that DUP can be reduced for individuals when early detection services exist in their communities (Melle et al, 2004), suggesting that while the determinants of DUP may not operate directly at the neighbourhood level, it does provide a suitable target for intervention strategies to reduce DUP.…”

Section: Resultssupporting

confidence: 86%

Examining evidence for neighbourhood variation in the duration of untreated psychosis

et al. 2010

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BackgroundFamily involvement in help-seeking is associated with a shorter duration of untreated psychoses [DUP], but it is unknown whether neighbourhood-level factors are also important.MethodsDUP was estimated for all cases of first-episode psychoses identified over 2 years in 33 Southeast London neighbourhoods (n=329). DUP was positively skewed and transformed to the natural logarithm scale. We fitted various hierarchical models, adopting different assumptions with regard to spatial variability of DUP, to assess whether there was evidence of neighbourhood heterogeneity in DUP, having accounted for a priori individual-level confounders.ResultsNeighbourhood-level variation in DUP was negligible compared to overall variability. A non-hierarchical model with age, sex and ethnicity covariates, but without area-level random effects, provided the best fit to the data.DiscussionNeighbourhood factors do not appear to be associated with DUP, suggesting its predictors lie at individual and family levels. Our results inform mental healthcare planning, suggesting that in one urbanised area of Southeast London, where you live does not affect duration of untreated psychosis.

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Section: Resultssupporting

confidence: 86%

Examining evidence for neighbourhood variation in the duration of untreated psychosis

et al. 2010

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“…The necessity of preventive treatment in bipolar disorder is indisputable to prevent relapses, reduce the risk of suicide and prevent psychosocial consequences of the episodes [23]; furthermore, delayed institution of preventive treatment is related to poor disease course in bipolar disorder [24]. Conversely, the importance of the time lag between the first onset of disorder symptoms and the initiation of treatment in psychotic disorders has been studied extensively; these studies reported that weak social support is related to delayed treatment in the first-episode psychotic patients [25,26]. In a study examining the effect of time before receiving the diagnosis of bipolar disorder on the clinical outcomes, McCraw et al [27] reported a relationship between the perceived social support and the time until diagnosis in bipolar disorder.…”

Section: Discussionmentioning

confidence: 99%

Bipolar disorder and perceived social support: relation with clinical course, and the role of suicidal behaviour

Kizilkurt

Giynas

Güleç

et al. 2019

Psychiatry and Clinical Psychopharmacology

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Objective: The objective in this study was to analyse the effects of the perceived social support from the family, friends and other important people in the lives of patients with bipolar disorder (BD) in remission on clinical course and suicidal behaviour in a multidimensional model. Method: The study conducted 100 patients diagnosed with BD-1(remission) according to DSM-5. All participants were administered Multidimensional Scale of Perceived Social Support(MSPSS), Young Mani Rating Scale(YMRS), Patient Health Questionnaire(PHQ-SADS,) Mood Disorder Diagnosis and Monitoring Form(SKIP-TURK), and Global Assessment of Functioning(GAF). Results: There was a significant negative correlation between the duration of untreated period (DUP), episodes length, illness duration, subthreshold depressive symptoms and their MSPSS scores (p < .05). There was a significant difference in the MSPSS total scores (not subscales) between the two groups divided according to suicidal behaviour (p = .03). There was a significant positive correlation between the GAF scores and the all MSPSS subscales scores. GAF and MSPSS friends_subscale scores were found to be predictors for suicide behaviour (respectively;Wald = 4.81, p = .028, OR = .93, %95 CI = 0.88-0.99;Wald = 4.71, p = .03, OR = 1.08, % 95 CI = 1,01-1,16). Conclusion: This study indicates that there are significant relationships between suicide attempts, DUP, episode length, subthreshold depressive symptoms, functioning and multidimensionally perceived social support. The fact that suicide attempt is related to total score and not to subscale scores of perceived social support shows the importance of the coexistence of all dimensions in the perceived social support area and emphasizes the necessity of examining these dimensions as a whole. Meanwhile, it is observed that the perceived friend_support along with functioning is associated with suicidal behaviour in BD.

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“…While it was possible to obtain data on a range of demographic and diagnostic variables, it was not possible to obtain detailed diagnostic and symptom data using clinical rating scales such as the SCAN[ 36 ] or YMRS[ 37 ]. Previous studies have indicated that factors such as employment status[ 38 ], social support[ 39 ], deliberate self-harm[ 40 ] and the clinical experience of clinicians who first assess patients may play a role in determining delays to diagnosis and treatment. Although it was possible to analyse data on age, gender, ethnicity and marital status in our study, it was not possible to obtain data on other factors from routinely recorded electronic health records.…”

Section: Discussionmentioning

confidence: 99%

Delays before Diagnosis and Initiation of Treatment in Patients Presenting to Mental Health Services with Bipolar Disorder

et al. 2015

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BackgroundBipolar disorder is a significant cause of morbidity and mortality. Although existing treatments are effective, there is often a substantial delay before diagnosis and treatment initiation. We sought to investigate factors associated with the delay before diagnosis of bipolar disorder and the onset of treatment in secondary mental healthcare.MethodRetrospective cohort study using anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust (SLaM) Biomedical Research Centre (BRC) Case Register on 1364 adults diagnosed with bipolar disorder between 2007 and 2012. The following predictor variables were analysed in a multivariable Cox regression analysis: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder. The outcomes were time to recorded diagnosis from first presentation to specialist mental health services (the diagnostic delay), and time to the start of appropriate therapy (treatment delay).ResultsThe median diagnostic delay was 62 days (interquartile range: 17–243) and median treatment delay was 31 days (4–122). Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18–3.06) and treatment delay (4.40, 3.63–5.62). Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33–0.41) and substance misuse disorders (0.44, 0.31–0.61). Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay.ConclusionsSome individuals experience a significant delay in diagnosis and treatment of bipolar disorder after initiation of specialist mental healthcare, particularly those who have prior diagnoses of alcohol and substance misuse disorders. These findings highlight a need for further study on strategies to better identify underlying symptoms and offer appropriate treatment sooner in order to facilitate improved clinical outcomes, such as developing specialist early intervention services to identify and treat people with bipolar disorder.

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Duration of untreated psychotic illness

Abstract: Both poor diffuse social support and a low socio-economic status seem to be relevant factors of a prolonged duration of untreated psychosis.

Cited by 29 publications

References 21 publications

Examining evidence for neighbourhood variation in the duration of untreated psychosis

Examining evidence for neighbourhood variation in the duration of untreated psychosis

Bipolar disorder and perceived social support: relation with clinical course, and the role of suicidal behaviour

Delays before Diagnosis and Initiation of Treatment in Patients Presenting to Mental Health Services with Bipolar Disorder

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