The period of untreated psychosis before treatment initiation:

Bergner, Erin M.; Leiner, Amy S.; Carter, Tandrea; Franz, Lauren; Thompson, Nancy J.; Compton, Michael T.

doi:10.1016/j.comppsych.2008.02.010

Cited by 69 publications

(86 citation statements)

References 34 publications

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“…The delay in treatment of psychotic symptoms until they reach crisis proportions may be due in part to families’ misattribution of symptoms and behaviors to typical adolescence or to stress or drugs (20,25). Although evolving symptoms may be subtle and nonspecific, this misattribution of symptoms may be due in part to reluctance on the part of patients and families to deal with the stigma of the label of a mental illness (2,12).…”

Section: Discussionmentioning

confidence: 99%

Families' Experience With Seeking Treatment for Recent-Onset Psychosis

Gerson¹,

Davidson²,

Booty³

et al. 2009

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Objective Qualitative research methods were used to understand the experiences of families seeking treatment for young people with recent-onset psychosis; such knowledge can inform services design. Methods The authors conducted open-ended interviews in 1999 through 2002 with family members of 13 patients with recent-onset nonaffective psychotic disorders in the New York metropolitan area, focusing on their experience in seeking treatment and engaging with mental health services. Results Family members described early lack of clarity of diagnosis and obstacles to obtaining treatment. Entry into the mental health system frequently occurred in the context of crisis, with African-American families specifically reporting police involvement. Inpatient hospitalization was depicted as traumatic yet offering relief. Aftercare was described as fragmented, and issues with third-party payers were paramount. Families expressed a desire for more education, information, and support and described their struggles with stigma. These data from families are presented in the context of more recent literature as to the efficacy of specialized treatment programs for early stages of psychotic disorder and their involvement of families. Conclusions These qualitative research data support the importance of involving and educating families about psychosis: its recognition, its treatment, and access to services. They also highlight the need to address stigma and implement structural changes in treatment that ensure continuity and coverage of care. Specialized first-episode psychosis services may address these issues, and they may minimize the traumatic experiences of involuntary hospitalization and police involvement early in treatment.

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Section: Discussionmentioning

confidence: 99%

Families' Experience With Seeking Treatment for Recent-Onset Psychosis

Gerson¹,

Davidson²,

Booty³

et al. 2009

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“…Extensive literature has additionally suggested that DUP is significantly associated with the severity of positive and negative symptoms at the time of presentation.Whereas limited previous reports have supported a link between DUP and grandiosity, bizarreness, 8,9 unusual or dangerous behaviour, 10,11 and avolition and poor social integration, 12 surprisingly little research to date has explored specifically what types of positive and negative symptoms are most associated with the length of untreated psychosis.…”

Section: Introductionmentioning

confidence: 95%

Associations between duration of untreated psychosis and domains of positive and negative symptoms

Birnbaum

Wan

Broussard

et al. 2015

Early Intervention Psych

Self Cite

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Aim The duration of untreated psychosis (DUP) has been established as an independent and significant predictor of negative outcomes in first-episode psychosis samples. Whereas literature has supported the association between DUP and severity of positive and negative symptoms, surprisingly little research to date has explored specifically what types of positive and negative symptoms are most associated with DUP. Methods DUP, Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) data were collected in 247 first-episode psychosis participants (mean age: 23.9 ± 4.8) between August 2008 and June 2013. Results DUP was significantly but modestly associated with the severity of hallucinations (ρ = 0.222; P = 0.001), delusions (r = 0.202; P = 0.003) and formal thought disorder (ρ = 0.138; P = 0.043) but was not associated with bizarre behaviour. DUP was significantly but modestly associated with SANS avolition-apathy (ρ = 0.164; P = 0.016) and anhedonia-asociality (r = 0.321; P < 0.001) subscales but was not associated with affective flattening or blunting, alogia or attention. Conclusions DUP is a complex and multifaceted phenomenon that is associated with early-course illness development. In efforts to improve early intervention services, prognoses and outcomes, it is vital to understand both the factors that contribute to lengthy untreated psychosis as well as the illness characteristics that are impacted by untreated psychosis.

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“…For example, among Chinese speaking individuals in Australia with anxiety disorders, the most frequently endorsed reason for seeking out formal services was problem recognition (Ho et al, 2008). Mismatches between “lay” and “expert” diagnoses have been associated with the length of untreated psychosis or other mental health problems (Bergner et al, 2008) and for postpartum hemorrhage documented in rural India (Sibley et al, 2005). While not fully consistent, this research suggests the need to consider controls.…”

Section: Theoretical Backgroundmentioning

confidence: 99%

Constructing illness: How the public in eight Western nations respond to a clinical description of “schizophrenia”

Ólafsdóttir

Pescosolido

2011

Social Science & Medicine

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According to classic and contemporary social theory, the community is crucial to how individuals respond to the onset of health problems. Cultural response to symptoms provides the foundation for lay diagnosis; offers a gauge for marking individual and societal health literacy; and reflects the cultural embeddedness of modern medical knowledge. Using data collected between 2004 and 2007 from the Stigma in Global Context – Mental Health Study (SGC-MHS) on the recognition of schizophrenia from vignettes describing individuals meeting DSM-IV criteria, we examine the nature and correlates of lay diagnosis. Focusing on Western societies in the SGC-MHS, we ask three questions regarding problem recognition in Bulgaria (N=255), Cyprus (N=253), Germany (N=382), Hungary (N=352), Iceland (N=291), Spain (N=327), Great Britain (N=289), and the United States (N=449). What is the cross-national variation in recognition of schizophrenia as a mental illness? Is lay diagnosis associated with individuals’ socio-demographic characteristics and/or their evaluation of underlying causes? Are lay diagnoses likely to shape the nature and direction of the illness career? We find lay diagnosis of “mental illness” to be high across these Western nations with some, though modest, difference across countries. Variation for the more specific diagnosis of “schizophrenia” is greater, though fairly consistent in country ordering. Lay diagnoses are shaped most consistently by attributions, inconsistently by socio-demographics, and generally associated with respondents’ treatment recommendations and expected outcomes. In light of assumptions about public beliefs and knowledge that often underlie research, community efforts, clinical programs, and health policy, these findings suggest that a greater understanding of the complexities of lay diagnosis is warranted.

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The period of untreated psychosis before treatment initiation:

Cited by 69 publications

References 34 publications

Families' Experience With Seeking Treatment for Recent-Onset Psychosis

Families' Experience With Seeking Treatment for Recent-Onset Psychosis

Associations between duration of untreated psychosis and domains of positive and negative symptoms

Constructing illness: How the public in eight Western nations respond to a clinical description of “schizophrenia”

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