Impact of early intervention services on duration of untreated psychosis: Data from the National EDEN prospective cohort study

2014 ◽  
Vol 159 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Max Marshall ◽  
Nusrat Husain ◽  
Natalie Bork ◽  
Imran B. Chaudhry ◽  
Helen Lester ◽  
...  
Keyword(s):  
Cohort Study ◽  
Early Intervention ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Duration Of Untreated Psychosis ◽  
Early Intervention Services ◽  
Intervention Services

scholarly journals Understanding Components of Duration of Untreated Psychosis and Relevance for Early Intervention Services in the Canadian Context: Comprendre les Composantes de la Durée de la Psychose Non Traitée et la Pertinence de Services D’intervention Précoce Dans le Contexte Canadien

2021 ◽  
pp. 070674372199267
Author(s):  
Ashok Malla ◽  
Manish Dama ◽  
Srividya Iyer ◽  
Ridha Joober ◽  
Norbert Schmitz ◽  
...  
Keyword(s):  
Early Intervention ◽  
Help Seeking ◽  
Multivariate Analyses ◽  
Patient Characteristics ◽  
Pathways To Care ◽  
Duration Of Untreated Psychosis ◽  
Present Sample ◽  
Early Intervention Services ◽  
Rapid Access ◽  
Intervention Services

Background: Clinical, functional, and cost-effectiveness outcomes from early intervention services (EIS) for psychosis are significantly associated with the duration of untreated psychosis (DUP) for the patients they serve. However, most EIS patients continue to report long DUP, while a reduction of DUP may improve outcomes. An understanding of different components of DUP and the factors associated with them may assist in targeting interventions toward specific sources of DUP. Objectives: To examine the components of DUP and their respective determinants in order to inform strategies for reducing delay in treatment in the context of an EIS. Methods: Help-seeking (DUP-H), Referral (DUP-R), and Administrative (DUP-A) components of DUP, pathways to care, and patient characteristics were assessed in first episode psychosis ( N = 532) patients entering an EIS that focuses on systemic interventions to promote rapid access. Determinants of each component were identified in the present sample using multivariate analyses. Results: DUP-H (mean 25.64 ± 59.00) was longer than DUP-R (mean = 14.95 ± 45.67) and DUP-A (mean 1.48 ± 2.55). Multivariate analyses showed that DUP-H is modestly influenced by patient characteristics (diagnosis and premorbid adjustment; R 2 = 0.12) and DUP-R by a combination of personal characteristics (age of onset and education) and systemic factors (first health services contact and final source of referral; R 2 = 0.21). Comorbid substance abuse and referral from hospital emergency services have a modest influence on DUP-A ( R 2 = 0.08). Patients with health care contact prior to onset of psychosis had a shorter DUP-H and DUP-R than those whose first contact was after psychosis onset (F(1, 498) = 4.85, P < 0.03 and F(1, 492) = 3.34, P < 0.07). Conclusions: Although much of the variance in DUP is unexplained, especially for help-seeking component, the systemic portion of DUP may be partially determined by relatively malleable factors. Interventions directed at altering pathways to care and promote rapid access may be important targets for reducing DUP. Simplifying administrative procedures may further assist in reducing DUP.

scholarly journals Outcome measures in early psychosis

2007 ◽  
Vol 191 (S50) ◽  
pp. s58-s63 ◽  
Author(s):  
Swaran P. Singh
Keyword(s):  
Early Intervention ◽  
Clinical Outcome ◽  
Recent Literature ◽  
Duration Of Untreated Psychosis ◽  
Short Term ◽  
Detection Function ◽  
Early Intervention Services ◽  
Time Points ◽  
Intervention Services ◽  
Precise Time

BackgroundDuration of untreated psychosis (DUP) is considered an important predictor of short-term clinical outcomeAimsTo explore the evolution of the concept of DUP, synthesise the evidence for its predictive value, highlight the problems in measurement, and consider the potential pitfalls of using DUP as a measure of the effectiveness of early intervention servicesMethodA survey of recent literature was conductedResultsSeveral studies and two systematicreviews confirm that DUP has a robust but moderate effecton outcome in schizophrenia. Studies vary widely in how DUP is defined and measured, since identifying precise time points when psychosis emerges and remits is conceptually ambiguous and clinically difficultConclusionsStandardised measurement of DUP is a vital first step in allowing comparisons between studies. Duration of untreated psychosis is a relevant measure only of the early detection function of early intervention services

Comparative analysis of pathways to early intervention services and duration of untreated psychosis in two Canadian cities

2016 ◽  
Vol 11 (6) ◽  
pp. 517-521 ◽  
Author(s):  
Nina Flora ◽  
Kelly K. Anderson ◽  
Manuela Ferrari ◽  
Andrew Tuck ◽  
Suzanne Archie ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Early Intervention ◽  
Duration Of Untreated Psychosis ◽  
Early Intervention Services ◽  
Intervention Services

scholarly journals Ethnic variations in pathways into early intervention services for psychosis

2013 ◽  
Vol 202 (4) ◽  
pp. 277-283 ◽  
Author(s):  
Sharif Ghali ◽  
Helen L. Fisher ◽  
John Joyce ◽  
Barnaby Major ◽  
Lorna Hobbs ◽  
...  
Keyword(s):  
Early Intervention ◽  
Ethnic Groups ◽  
Psychotic Disorders ◽  
Black Patient ◽  
Study Data ◽  
Duration Of Untreated Psychosis ◽  
Early Intervention Services ◽  
Patient Groups ◽  
Intervention Services ◽  
Ethnic Variations

BackgroundEthnic variations have previously been identified in the duration of untreated psychosis (DUP) and pathways into psychiatric services. These have not been examined in the context of early intervention services, which may alter these trajectories.AimsTo explore ethnic differences in the nature and duration of pathways into early intervention services.MethodIn a naturalistic cohort study, data were collected for 1024 individuals with psychotic disorders accepted for case management by eight London early intervention services.ResultsDuration of untreated psychosis was prolonged in the White British group compared with most other ethnic groups. White British individuals were more likely to make contact with their general practitioner and less likely to be seen within emergency medical services. All Black patient groups were more likely than their White British counterparts to experience involvement of criminal justice agencies.ConclusionsVariations continue to exist in how and when individuals from different ethnic groups access early intervention services. These may account for disparities in DUP.

Intraoral Vacuum of Breast-Feeding Newborns Within the First 24 Hr

2016 ◽  
Vol 18 (4) ◽  
pp. 445-453 ◽  
Author(s):  
Feng Zhang ◽  
Haiou Xia ◽  
Xia Li ◽  
Ling Qin ◽  
Hongmei Gu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Early Intervention ◽  
Cesarean Section ◽  
Breast Feeding ◽  
Prospective Cohort Study ◽  
Pressure Sensor ◽  
Prospective Cohort ◽  
Confounding Factors ◽  
Delayed Onset ◽  
Delayed Onset Of Lactation

Objectives: To explore whether newborns born via Cesarean section have a weaker intraoral vacuum compared with those born vaginally and to determine whether a weaker intraoral vacuum is related to a delayed onset of lactation. Methods: For this prospective cohort study, 71 mother–infant dyads were enrolled and divided into birthing groups, vaginal or Cesarean. The newborn intraoral vacuum was measured via a tube placed alongside the nipple and connected to a pressure sensor during a breast-feeding session within the first 24 hr after birth. Onset of lactation was confirmed by maternal perception of breast fullness. The intraoral vacuum and its relationship with the onset of lactation were analyzed. Results: After adjustment for confounding factors, the peak intraoral vacuum was −19.50 kPa in the vaginal group, which was significantly stronger than the −13.78 kPa in the Cesarean group ( p = .005). Additionally, the baseline intraoral vacuum in the vaginal group (−2.35 kPa) was significantly stronger than that in the Cesarean group (−1.18 kPa; p = .022). Strength of the newborn intraoral vacuum was associated with the time of onset of maternal lactation. Conclusion: Cesarean section may weaken newborns’ intraoral vacuum within the first 24 hr after birth. Stronger intraoral vacuum was related to earlier onset of lactation. Early intervention aimed at the weaker intraoral vacuum should be provided to promote the onset of lactation.

scholarly journals Invited commentary on … Ethnic variations in pathways into early intervention services for psychosis

2013 ◽  
Vol 202 (4) ◽  
pp. 284-285 ◽  
Author(s):  
Richard Warner
Keyword(s):  
Early Intervention ◽  
Duration Of Untreated Psychosis ◽  
Early Intervention Services ◽  
Poor Outcome ◽  
Long Duration ◽  
Intervention Services ◽  
Ethnic Variations ◽  
Early Intervention In Psychosis

SummaryAdvocates of early intervention in psychosis choose to treat the association between long duration of untreated psychosis (DUP) and poor outcome as evidence that reducing DUP will improve outcomes. I question this view and argue that DUP does not predict outcome but rather that mode of onset of psychosis predicts DUP and outcome.

Bottom Line: Who Pays the Bill for Early Intervention Services?

ASHA Leader ◽  
2013 ◽  
Vol 18 (2) ◽  
pp. 26-27
Author(s):  
Janet McCarty ◽  
Laurie Havens
Keyword(s):  
Early Intervention ◽  
Private Insurance ◽  
Infants And Toddlers ◽  
Bottom Line ◽  
Early Intervention Services ◽  
Intervention Services

Medicaid, federal education funds and private insurance all cover the costs of speech-language and hearing services for infants and toddlers. Learn who pays for what.

Organizational Justice and Health of Employees: Prospective Cohort Study.

2013 ◽  
Author(s):  
Mika Kivimaki ◽  
Marko Elovainio ◽  
Jussi Vahtera ◽  
Marianna Virtanen ◽  
Jane E. Ferrie
Keyword(s):  
Cohort Study ◽  
Organizational Justice ◽  
Prospective Cohort Study ◽  
Prospective Cohort
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