Observations on parent/family factors that may influence the duration of untreated psychosis among African American first-episode schizophrenia-spectrum patients.

The duration of untreated psychosis (DUP) is a concept of importance in schizophrenia research from the perspective of secondary prevention. Although findings to date are mixed, several studies have demonstrated an inverse association between the duration of treatment delay and a variety of clinical and psychosocial outcomes. Research is needed to better understand the multifactorial determinants of the DUP and family-level influences on the DUP may prove to be important predictors. The authors present basic descriptive statistics and case histories of 10 parents/siblings of 6 African American first-episode patients. The mean DUP reported by the family members (five mothers, two fathers, one stepfather and two siblings) was 59.5 weeks (range 2-234). Family members' levels of knowledge of schizophrenia may not necessarily have a major impact upon the length of treatment delays. Among this small sample of relatives, early psychotic symptoms were often attributed to depression, lack of motivation or relational stressors. Family members' decisions to seek help often were solidified only after the emergence of unbearable psychotic symptoms or socially disruptive behaviors. Low concordance among family members' reports of the DUP and perceived barriers to accessing psychiatric services were unexpected findings. These preliminary observations may serve to generate hypotheses for further research that aims to elucidate the determinants of treatment delays in the early course of schizophrenia, especially among African American populations.