An exploratory evaluation of predictors of duration of untreated psychosis in first-episode psychosis in lower income patients

2021 ◽  
pp. 114203
Author(s):  
Ankita Mishra ◽  
Abha Bang Soni ◽  
Maithili S Umate ◽  
Chittaranjan Andrade
Keyword(s):  
First Episode Psychosis ◽  
First Episode ◽  
Lower Income ◽  
Duration Of Untreated Psychosis ◽  
Episode Psychosis

Retrospective study of first episode psychosis in the Dublin Southwest Mental Health Service: demographics, clinical profile and service evaluation of treatment

2017 ◽  
Vol 36 (4) ◽  
pp. 249-258 ◽  
Author(s):  
A.-M. Clarke ◽  
P. McLaughlin ◽  
J. Staunton ◽  
K. Kerins ◽  
B. Power ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Service ◽  
Family Intervention ◽  
First Episode Psychosis ◽  
First Episode ◽  
Psychological Interventions ◽  
Duration Of Untreated Psychosis ◽  
Episode Psychosis ◽  
Baseline Information ◽  
Healthcare Monitoring

ObjectiveIn Ireland, National Clinical Programmes are being established to improve and standardise patient care throughout the Health Service Executive. In line with internationally recognised guidelines on the treatment of first episode psychosis the Early Intervention in Psychosis (EIP) programme is being drafted with a view to implementation by mental health services across the country. We undertook a review of patients presenting with a first episode of psychosis to the Dublin Southwest Mental Health Service before the implementation of the EIP. This baseline information will be used to measure the efficacy of our EIP programme.MethodsPatients who presented with a first episode psychosis were retrospectively identified through case note reviews and consultation with treating teams. We gathered demographic and clinical information from patients as well as data on treatment provision over a 2-year period from the time of first presentation. Data included age at first presentation, duration of untreated psychosis, diagnosis, referral source, antipsychotic prescribing rates and dosing, rates of provision of psychological interventions and standards of physical healthcare monitoring. Outcome measures with regards to rates of admission over a 2-year period following initial presentation were also recorded.ResultsIn total, 66 cases were identified. The majority were male, single, unemployed and living with their family or spouse. The mean age at first presentation was 31 years with a mean duration of untreated psychosis of 17 months. Just under one-third were diagnosed with schizophrenia. Approximately half of the patients had no contact with a health service before presentation. The majority of patients presented through the emergency department. Two-thirds of all patients had a hospital admission within 2 years of presentation and almost one quarter of patients had an involuntary admission. The majority of patients were prescribed antipsychotic doses within recommended British National Formulary guidelines. Most patients received individual support through their keyworker and family intervention was provided in the majority of cases. Only a small number received formal Cognitive-Behavioural Therapy. Physical healthcare monitoring was insufficiently recorded in the majority of patients.ConclusionsThere is a shortage of information on the profile and treatment of patients presenting with a first episode of psychosis in Ireland. This baseline information is important in evaluating the efficacy of any new programme for this patient group. Many aspects of good practice were identified within the service in particular with regards to the appropriate prescribing of antipsychotic medication and the rates of family intervention. Deficiencies remain however in the monitoring of physical health and the provision of formal psychological interventions to patients. With the implementation of an EIP programme it is hoped that service provision would improve nationwide and to internationally recognised standards.

Duration of untreated psychosis and neuropsychological function in first episode psychosis

2007 ◽  
Vol 95 (1-3) ◽  
pp. 103-110 ◽  
Author(s):  
Julia M. Lappin ◽  
Kevin D. Morgan ◽  
Craig Morgan ◽  
Paola Dazzan ◽  
Abraham Reichenberg ◽  
...  
Keyword(s):  
First Episode Psychosis ◽  
First Episode ◽  
Neuropsychological Function ◽  
Duration Of Untreated Psychosis ◽  
Episode Psychosis

Impact of duration of untreated psychosis in short‐term response to treatment and outcome in antipsychotic naïve first‐episode psychosis

2019 ◽  
Vol 14 (6) ◽  
pp. 677-683 ◽  
Author(s):  
Daniel A. Cavalcante ◽  
Luccas S. Coutinho ◽  
Bruno B. Ortiz ◽  
Mariane N. Noto ◽  
Quirino Cordeiro ◽  
...  
Keyword(s):  
First Episode Psychosis ◽  
Response To Treatment ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Short Term ◽  
Episode Psychosis ◽  
Term Response

scholarly journals Duration of untreated psychosis and need for admission in patients who engage with mental health services in the prodromal phase

2015 ◽  
Vol 207 (2) ◽  
pp. 130-134 ◽  
Author(s):  
Lucia R. Valmaggia ◽  
Majella Byrne ◽  
Fern Day ◽  
Matthew R. Broome ◽  
Louise Johns ◽  
...  
Keyword(s):  
Minority Group ◽  
First Episode Psychosis ◽  
First Episode ◽  
First Year ◽  
Compulsory Treatment ◽  
Duration Of Untreated Psychosis ◽  
Short Term ◽  
Prodromal Phase ◽  
Episode Psychosis ◽  
Poor Outcomes

BackgroundIt is unknown whether prodromal services improve outcomes in those who go on to develop psychosis, and whether these patients are demographically different from the overall first-episode population.AimsTo compare sociodemographic features, duration of untreated psychosis, hospital admission and frequency of compulsory treatment in the first year after the onset of psychosis in patients who present to prodromal services with patients who did not present to services until the first episode of psychosis.MethodWe compared two groups of patients with first-episode psychosis: one who made transition after presenting in the prodromal phase and the other who had presented with a first episode.ResultsThe patients who had presented before the first episode were more likely to be employed and less likely to belong to an ethnic minority group. They had a shorter duration of untreated psychosis, and were less likely to have been admitted to hospital and to have required compulsory treatment.ConclusionsPatients who develop psychosis after being engaged in the prodromal phase have a better short-term clinical outcome than patients who do not present until the first episode. Patients who present during first episodes may be more likely to have sociodemographic features associated with relatively poor outcomes.

Pathways to Care, Duration of Untreated Psychosis and Treatments Received by Patients with First-Episode Psychosis

2011 ◽  
Vol 26 (S2) ◽  
pp. 1394-1394
Author(s):  
D. Giacco ◽  
A. Fiorillo ◽  
V. Del Vecchio ◽  
M. Luciano ◽  
G. Sampogna ◽  
...  
Keyword(s):  
Health Professionals ◽  
Suicide Attempts ◽  
Hospital Admissions ◽  
Psychiatric Treatment ◽  
First Episode Psychosis ◽  
Pathways To Care ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Long Term Outcome ◽  
Episode Psychosis

IntroductionPathways to care and duration of untreated psychosis (DUP) strongly influence the long-term outcome of schizophrenia.AimsTo investigate pathways to care, duration of untreated psychosis (DUP) and treatments received by a sample of individuals aged between 18 and 35 years meeting diagnostic criteria for psychosis.MethodsPathways to care and DUP were explored by an “ad-hoc” schedule administered to patients and caregivers.ResultsThe sample consists of 30 patients. The first episode of psychosis, which occurred at 19.7 (± 4.7) years, was characterized by negative symptoms and disorganized behaviours in more than half of the sample, suicide attempts (28%) and hospital admissions (26%). DUP was 41.6 ± 60.4 weeks, being longer than that reported in international literature. In 76% of cases patients’ relatives asked for a first contact with health professionals, referring the patients to psychiatrists (34% of cases), general practitioners (31%), neurologists (21%) or psychologists (13%). When professionals other than psychiatrists were contacted, the interval between the contact and receipt of appropriate psychiatric treatment (according to the current guidelines) was particularly long (15.2 ± 32.1 weeks). 34% of patients were treated with a monotherapy of psychotropic drugs: 24% with antipsychotics, 7% with anxiolytics and 3% with antidepressants; 48% received a poly-pharmacotherapy. 35% were treated with psychotherapy (in most of the cases cognitive-behavioural therapy), which was the only treatment for 18% of patients.ConclusionsThese results emphasize the need to train health professionals on diagnosis and treatment of first episode psychosis. DUP may be reduced by anti-stigma campaigns among general population.

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