Pathways to care of first-admitted subjects with psychosis in South-Western France

Abstract

The delay in access to care may not be totally attributed to inadequate management by health professionals, but may be a characteristic of the disease itself, at least in part independent of the organization of the health system.

Measuring pathways to care in first-episode psychosis: A systematic review

“…Some papers sought to answer more than one question. Six studies explored reasons for treatment delays and barriers in pathways to care in first-episode psychosis (Larsen et al, 1998, Lincoln et al, 1998, Addington et al, 2002, Etheridge et al, 2004, Fuchs and Steinert, 2004, Norman et al, 2004, five explored the influence of ethnicity on pathways (Cole et al, 1995, Burnett et al, 1999, Morgan et al, 2005b, Morgan et al, 2005, Bhugra et al, 2000 Two studies explored social determinants of pathways (Bhugra et al, 2000, Cougnard et al, 2004, one investigated clinical influences on pathways (Cougnard et al, 2004) and two articles examined the relationship between DUP and pathways to care (Larsen et al, 1998, Chong et al, 2005. One paper looked at the usefulness of a pathway to care model and tool (Perkins et al, 1999), one sought to understand help-seeking contacts (Fuchs and Steinert, 2004), one investigated the time point in early psychosis when antipsychotics were initiated (Cougnard et al, 2004) and one paper made cross-national comparison on the epidemiology and presentation of first-episode psychosis (Sartorious et al, 1986)].…”

“…Most studies came from the UK (Cole et al, 1995, Burnett et al, 1999, Morgan et al, 2005b, Morgan et al, 2005, Bhugra et al, 2000, Etheridge et al, 2004, three were from other European countries (Larsen et al, 1998, Cougnard et al, 2004, Fuchs and Steinert, 2004, three were from North America/Canada (Perkins et al, 1999, Addington et al, 2002, Norman et al, 2004 and one each from Australia (Lincoln et al, 1998) and Singapore (Chong et al, 2005) and one study was multinational (Sartorious et al, 1986). The smallest study had 9 subjects (Perkins et al, 1999) while the largest had 1379 subjects (Sartorious et al, 1986) the mean number of subjects being 210 (SD= 352; mode 86).…”

“…We obtained copies of measures used in eleven studies (Sartorious et al, 1986, Perkins et al, 1999, Lincoln et al, 1998, Bhugra et al, 2000, Addington et al, 2002, Cougnard et al, 2004, Etheridge et al, 2004, Norman et al, 2004, Morgan et al, 2005b, Morgan et al, 2005, Burnett et al, 1999. In one study, the pathways measure was available in French with no English translation (Cougnard et al, 2004).…”

“…In one study, the pathways measure was available in French with no English translation (Cougnard et al, 2004). Five studies had developed their own measures of pathways for the specific purposes of that study (Sartorious et al, 1986, Cole et al, 1995, Perkins et al, 1999, Cougnard et al, 2004, Fuchs and Steinert, 2004.…”

“…This tool was also used by one other study (Addington et al, 2002). Two studies reported using semi-structured questionnaires (Cole et al, 1995, Cougnard et al, 2004) and one reported simply asking patients for information on their contacts with professionals before admission and their pathways to care (Fuchs and Steinert, 2004). One study used the Encounter Form (Gater et al, 1991) and two others based their measures on other assessment tools (Etheridge et al, 2004, Norman et al, 2004; one on the IRIS audit tool kit (Partnerships, 2001) and the other, the Circumstances of Onset and Relapse Schedule (CORS) which is based on the Interview for the Retrospective Assessment of Schizophrenia (IRAOS) (Hafner et al, 1992).…”