scholarly journals Initiatives to shorten duration of untreated psychosis: systematic review

2011 ◽  
Vol 198 (4) ◽  
pp. 256-263 ◽  
Author(s):  
Brynmor Lloyd-Evans ◽  
Michelle Crosby ◽  
Sarah Stockton ◽  
Stephen Pilling ◽  
Lorna Hobbs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Early Detection ◽  
Public Awareness ◽  
National Level ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Early Intervention Services ◽  
Awareness Campaigns ◽  
Poor Outcomes ◽  
Practitioner Education

BackgroundLong duration of untreated psychosis (DUP) is common and associated with poor outcomes. Strategies to enhance early detection of first-episode psychosis have been advocated.AimsTo evaluate initiatives for early detection of psychosis.MethodSystematic review of available evidence on the effectiveness of early detection initiatives to reduce the DUP.ResultsThe review included 11 studies which evaluated 8 early detection initiatives. Evidence suggests that general practitioner education campaigns and dedicated early intervention services do not by themselves reduce DUP or generate more treated cases. Evidence for multifocus initiatives is mixed: intensive campaigns targeting the general public as well as relevant professionals may be needed. No studies evaluated initiatives targeting young people or professionals from non-health organisations.ConclusionsHow early detection can be achieved is not clear. Evidence is most promising for intensive public awareness campaigns: these require organisation and resourcing at a regional or national level. More good-quality studies are needed to address gaps in knowledge.

Early detection of psychosis – Establishing a service for persons at risk

2009 ◽  
Vol 24 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Frauke Schultze-Lutter ◽  
Stephan Ruhrmann ◽  
Joachim Klosterkötter
Keyword(s):  
Early Detection ◽  
Mental Health Professionals ◽  
Public Awareness ◽  
Local Population ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Private Practitioners ◽  
Awareness Campaigns ◽  
Counselling Services ◽  
German Citizenship

AbstractPurposeThe establishment phase of an early detection centre for prodromal psychosis is introduced and characterised, along with its detaining and promoting factors within a universal multi-payer health care system.MethodAcross the first six years (1998–2003), users' characteristics are compared between different diagnostic groups and to the local population statistics; and, for an exemplary 12-months period (3-1-2002 to 2-28-2003), the characteristics of telephone contacts with the service are studied.ResultsRising steadily in number across the first three years, 872 persons, predominately of German citizenship and higher education, consulted the service until 2003, 326 with first-episode psychosis and 144 not fulfilling criteria for a current or beginning psychosis. Of the 402 putatively prodromal patients, 94% reported predictive basic symptoms, 68.9% attenuated and 20.6% transient psychotic symptoms. Most contacts by persons meeting any prodromal criterion were initiated by mental health professionals (psychiatrists or psychologists) and counselling services.ConclusionSupported by public awareness campaigns, an early detection service is well received by its users and private practitioners as reflected by the large proportion of referrals from the latter. However, persons of non-German background as well as of lower education were underrepresented indicating that these sub-groups should be approached by tailored programmes.

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.

scholarly journals Safe investigation of isolated change in bowel habit with a flexible sigmoidoscopy? A systematic review and meta-analysis

2019 ◽  
Vol 101 (6) ◽  
pp. 379-386
Author(s):  
PJJ Herrod ◽  
H Boyd-Carson ◽  
B Doleman ◽  
JEM Blackwell ◽  
EJO Hardy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Bleeding ◽  
Flexible Sigmoidoscopy ◽  
Public Awareness ◽  
Meta Analysis ◽  
Bowel Cancer ◽  
Bowel Habit ◽  
Presenting Symptoms ◽  
Awareness Campaigns ◽  
Language Restriction

IntroductionPublic awareness campaigns have led to increasing referrals of patients to colorectal surgery for possible cancer. Change in bowel habit, is traditionally described as a symptom of a left sided bowel cancer. If this is the case in practice, it raises the potentially attractive option of investigating such patients with flexible sigmoidoscopy only. This study sought to systematically review the literature describing tumour location of patients with bowel cancer presenting with left-sided symptoms to establish the safety of potential investigation of these patients with flexible sigmoidoscopy alone.MethodsA systematic review of studies reporting both the presenting symptoms of patients with bowel cancer and the location of their cancer in the bowel was prospectively registered (CRD42017072492). MEDLINE, EMBASE and CENTRAL were searched with no date or language restriction.ResultsSeven studies were included. Isolated change in bowel habit (with or without rectal bleeding) was a presenting symptom of 73% (95% CI 41–96%, I2 = 99%) of left-sided cancers but also in 13% (95% CI 2–30%, I2 = 96%) of right-sided cancers. In all patients with cancer who presented with isolated change in bowel habit (with or without rectal bleeding), the cancer was right sided in 8% (95% CI 4–12%, I2 = 69%).ConclusionsThere is a higher than expected risk that if a cancer is diagnosed in a patient presenting with either an isolated change in bowel habit or a combination of change in bowel habit with rectal bleeding, the cancer may be right sided.

scholarly journals One-year effect of changing duration of untreated psychosis in a single catchment area

2007 ◽  
Vol 191 (S51) ◽  
pp. s128-s132 ◽  
Author(s):  
Tor K. Larsen ◽  
Ingrid Melle ◽  
Svein Friss ◽  
Inge Joa ◽  
Jan Olav Johannessen ◽  
...  
Keyword(s):  
Early Detection ◽  
Control Sample ◽  
Historical Control ◽  
Healthcare Sector ◽  
First Episode ◽  
Control Group ◽  
Experimental Sample ◽  
Duration Of Untreated Psychosis ◽  
Two Samples ◽  
One Year

BackgroundThere is highly replicated positive correlation between longer duration of untreated psychosis and poorer outcomeAimsTo study the effect of early intervention in first psychosis on one-year outcome using an historical quasi-experimental designMethodWe compare the outcome of two samples of first-episode psychosis from the same healthcare district at different time periods. The historical control sample was assessed during 19931994, before the establishment of a system for early detection of psychosis. The experimental sample is the early detection sample in the Early Treatment and Intervention in Psychosis study assessed during 1997–2000ResultsAt 1-year follow-up, the early detection group was younger, had a smaller fraction of individuals with schizophrenia, had less severe negative and general symptoms and had more friends in the past year than the historical control group. No differences were found in clinical course (remission, relapse, continuously psychotic) or positive symptoms, but more patients in the early detection sample were treated as outpatients without hospitalisationConclusionsEarly detection of schizophrenia in one healthcare sector is associated with less severe deterioration at 1 year

scholarly journals The Role of Untreated Psychosis in Neurodegeneration: A Review of Hypothesized Mechanisms of Neurotoxicity in First-Episode Psychosis

2014 ◽  
Vol 59 (10) ◽  
pp. 513-517 ◽  
Author(s):  
Kelly K Anderson ◽  
Aristotle Voineskos ◽  
Benoit H Mulsant ◽  
Tony P George ◽  
Kwame J McKenzie
Keyword(s):  
Systematic Review ◽  
Structural Changes ◽  
First Episode Psychosis ◽  
Brain Morphology ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Persistent Activity ◽  
Duration Of Untreated Psychosis ◽  
Episode Psychosis

For over 20 years, studies have tried to measure the association between the duration of untreated psychosis (DUP) and changes in brain morphology. A hypothesis that untreated psychosis is neurotoxic has been postulated, but the mechanisms of that toxicity have not been described. We re-analyzed papers collected for a systematic review to extract data on the hypotheses that have been generated on the potential mechanisms by which DUP could impact brain morphology in first-episode psychosis. Dopaminergic hyperactivity, prolonged hypothalamic–pituitary–adrenal activation, and persistent activity of catecholamines have been hypothesized as mechanisms to explain these associations. However, the question remains as to whether the observed structural changes are permanent or may be reversed via antipsychotic treatment.

scholarly journals Specific support needs and experiences of carers of people with frontotemporal dementia: A systematic review

Dementia ◽  
2021 ◽  
pp. 147130122110229
Author(s):  
Sara A Tookey ◽  
Caroline V Greaves ◽  
Jonathan D Rohrer ◽  
Joshua Stott
Keyword(s):  
Systematic Review ◽  
Frontotemporal Dementia ◽  
Professional Education ◽  
Subjective Experience ◽  
Public Awareness ◽  
Support Needs ◽  
Informal Carer ◽  
Framework Analysis ◽  
Awareness Campaigns ◽  
Relationship Change

Introduction Frontotemporal dementia (FTD) is one of the most common types of dementia in persons younger than 65 years of age. Diagnosis is often delayed due to slow, gradual decline and misinterpretation of ‘non-typical’ dementia symptoms. Informal carers of people with FTD experience greater levels of overall burden than carers of people with other forms of dementia. The aim of this systematic review was to describe the subjective experience of being an informal carer of a person with FTD and to identify the specific needs, coping strategies and helpful support resources of this carer population. Methods Four electronic databases were used to search for published literature presenting experiences of carers of people with FTD between January 2003 and July 2019. Search strategy followed PRISMA guidelines. Findings were analysed using framework analysis, employing five stages of analysis to develop a coding index and thematic framework that included key aspects of the carer experience, which were grouped into themes and presented in a narrative format. Results 1213 articles were identified in total. Twelve studies were included in the final synthesis of the review. Six themes were identified: ‘Challenging road to and receipt of diagnosis’, ‘relationship change and loss’, ‘challenging experiences in caring’, ‘positive experiences and resilience’, ‘coping’ and ‘support needs’. Discussion Findings highlight an increased need for carers of people with FTD to receive support during the pre-diagnostic stage, including support to manage symptoms. Further research should explore relationship changes and loss amongst carers to inform approaches for carer support. In conclusion, the lack of knowledge and unique needs of carers highlight the importance of public awareness campaigns and healthcare professional education to support carers with FTD symptom impact.

scholarly journals Coronavirus Outbreak: Health Care Measures taken by Pakistan

2020 ◽  
Vol 1 (supplement) ◽  
pp. 4
Author(s):  
Danish Nadeem
Keyword(s):  
Health Care ◽  
Short Communication ◽  
Public Awareness ◽  
National Level ◽  
Multiple Measures ◽  
Awareness Campaigns ◽  
Corona Virus ◽  
Tertiary Hospitals ◽  
The Government

Coronavirus pandemic is affecting the whole world. The number of cases have been sharply increased in Pakistan. The Government of Pakistan have taken multiple measures in order to control the epidemic. National actionplanhasbeendesignedtotackletheoutbreak.Smartlockdownwasimposedinmanydistricts. Thirty- five tertiary hospitals were declared treatment centers for the corona virus patients, 2942 isolation beds were specified and 57 quarantine facilities were provided in 139 districts of Pakistan. Diagnostic facilities all across the country took up to forty-six thousand test per day. Massive public awareness campaigns regarding prevention were introduced. All these timely measures resulted in remarkable control of coronavirus cases. The purpose of this short communication is to review the healthcare measures taken at national level to combat against the pandemic.

Duration of untreated psychosis and neurocognitive functioning in first-episode psychosis: a systematic review and meta-analysis

2017 ◽  
Vol 48 (10) ◽  
pp. 1592-1607 ◽  
Author(s):  
K. Allott ◽  
D. Fraguas ◽  
C. F. Bartholomeusz ◽  
C. M. Díaz-Caneja ◽  
C. Wannan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Wisconsin Card Sorting Test ◽  
First Episode Psychosis ◽  
Small Samples ◽  
First Episode ◽  
Significant Finding ◽  
Duration Of Untreated Psychosis ◽  
Card Sorting ◽  
Episode Psychosis

AbstractBackgroundPrevious reviews suggest there is minimal evidence for an association between duration of untreated psychosis (DUP) and neurocognition. This is based on tallied findings of studies with small samples and neurocognition viewed as a single construct. We aimed to conduct a systematic review and meta-analysis examining the association between DUP and individual neurocognitive domains and tests in first-episode psychosis (FEP).MethodMOOSE and PRISMA guidelines were followed. Forty-three studies involving 4647 FEP patients were included. For studies providing correlations between DUP and neurocognition, 12 separate meta-analyses were performed based on neurocognitive domains/indices. The influence of demographic/clinical variables was tested using weighted linear meta-regression analyses.ResultsThe relationship between DUP and most neurocognitive domains/indices was not significant. Longer DUP was associated with a larger cognitive deterioration index, i.e. current minus premorbid intellectual functioning (N = 4; mean ES −0.213, 95% confidence interval (CI) (−0.344 to −0.074), p = 0.003). Findings were homogeneous, with no evidence of publication bias or significant influence from moderators. For studies providing mean and standard deviations for neurocognitive measures and DUP, 20 meta-regressions were performed on individual neurocognitive tests. One significant finding emerged showing that longer DUP was associated with fewer Wisconsin Card Sorting Test-perseverative errors (mean ES −0.031, 95% CI (−0.048 to −0.013), p < 0.001). Exploratory meta-regressions in studies with mean DUP <360 days showed longer DUP was significantly associated with poorer performance on Trail Making Test A and B and higher Full-Scale IQ.ConclusionThere may not be a generalised association between DUP and neurocognition, however, specific cognitive functions may be associated with longer DUP or delayed help-seeking.

Sign in / Sign up

Export Citation Format

Share Document