Pathways to psychiatric care and duration of untreated psychosis in first-episode psychosis patients

Abstract

To reduce the time of untreated psychosis it is necessary to know the patients' pathways to psychiatric care. For this reason we interviewed 50 first-episode patients with the Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS) for information about duration of untreated psychosis (DUP) and about their help-seeking contacts before psychiatric admission. In contrast to other findings of long DUP, 50 % of our patients were admitted after 8 weeks (median) of untreated positive symptoms. The mean value of 62 weeks corresponds well with results of other studies. There were important differences in DUP depending on which kind of statistical parameter (median or mean) was used. Contrary to studies from other countries only 24 % of our patients had their first contact with a general practitioner. Between patients with short (< 1 year) and long (> 1 year) DUP no significant differences were found in contacts with helpers and in the duration from the first contact until psychiatric admission. However, patients with long DUP made their first contact with helpers significantly later after the beginning of positive symptoms than patients with short DUP.