PURPOSE: Interventions aimed at influencing specific pathways to care may reduce the duration of untreated psychosis (DUP). The purpose of this study was to reduce delay in referral to an early intervention service following first contact for help seeking for psychosis in a defined urban catchment area. METHODS: Using a historical control design, we conducted a targeted intervention comprised of intensive training and education regarding first onset of psychosis and benefits of early intervention with all potential points of contact in pathways to care in a defined catchment area of a specialized early intervention (EI) service. Data collected on different components of DUP [help seeking (H-DUP) and referral (R-DUP)] and demographic and clinical characteristics on patients seeking treatment of first episode of a psychotic (FEP) disorder accepted in the EI service for 3 years before and 3 years after the intervention were contrasted. No other systemic changes occurred in this catchment area during this period. RESULTS: There was a significant increase in the number of cases of FEP referred to the EI service post-intervention from hospitals other than the parent institute, in the proportion with a diagnosis of affective psychosis and proportion of patients from a lower socioeconomic status (SES). Although largest proportion of patients continued to make their first contact with community services, the latter failed to refer cases of psychosis to the EI service despite making a large number of mostly non-cases (for psychosis). The intervention had no direct effect on total DUP, R-DUP or H-DUP. After controlling for diagnosis and SES, post-intervention, R-DUP remained significantly lower for patients making first contact with the emergency service of the parent institute. CONCLUSIONS: The intervention failed to reduce R-DUP for patients making contact with or referred from community services and most patients still used hospital resources to enter treatment at the EI service.
PURPOSE: Interventions aimed at influencing specific pathways to care may reduce the duration of untreated psychosis (DUP). The purpose of this study was to reduce delay in referral to an early intervention service following first contact for help seeking for psychosis in a defined urban catchment area. METHODS: Using a historical control design, we conducted a targeted intervention comprised of intensive training and education regarding first onset of psychosis and benefits of early intervention with all potential points of contact in pathways to care in a defined catchment area of a specialized early intervention (EI) service. Data collected on different components of DUP [help seeking (H-DUP) and referral (R-DUP)] and demographic and clinical characteristics on patients seeking treatment of first episode of a psychotic (FEP) disorder accepted in the EI service for 3 years before and 3 years after the intervention were contrasted. No other systemic changes occurred in this catchment area during this period. RESULTS: There was a significant increase in the number of cases of FEP referred to the EI service post-intervention from hospitals other than the parent institute, in the proportion with a diagnosis of affective psychosis and proportion of patients from a lower socioeconomic status (SES). Although largest proportion of patients continued to make their first contact with community services, the latter failed to refer cases of psychosis to the EI service despite making a large number of mostly non-cases (for psychosis). The intervention had no direct effect on total DUP, R-DUP or H-DUP. After controlling for diagnosis and SES, post-intervention, R-DUP remained significantly lower for patients making first contact with the emergency service of the parent institute. CONCLUSIONS: The intervention failed to reduce R-DUP for patients making contact with or referred from community services and most patients still used hospital resources to enter treatment at the EI service.
Authors: J O Johannessen; T H McGlashan; T K Larsen; M Horneland; I Joa; S Mardal; R Kvebaek; S Friis; I Melle; S Opjordsmoen; E Simonsen; H Ulrik; P Vaglum Journal: Schizophr Res Date: 2001-08-01 Impact factor: 4.939
Authors: Max Birchwood; Charlotte Connor; Helen Lester; Paul Patterson; Nick Freemantle; Max Marshall; David Fowler; Shôn Lewis; Peter Jones; Tim Amos; Linda Everard; Swaran P Singh Journal: Br J Psychiatry Date: 2013-05-23 Impact factor: 9.319
Authors: Kelly K Anderson; Ross Norman; Arlene G MacDougall; Jordan Edwards; Lena Palaniyappan; Cindy Lau; Paul Kurdyak Journal: Can J Psychiatry Date: 2018-03-21 Impact factor: 4.356
Authors: Aubrey M Moe; Ellen B Rubinstein; Colin J Gallagher; David M Weiss; Amanda Stewart; Nicholas Jk Breitborde Journal: Risk Manag Healthc Policy Date: 2018-08-30