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Reducing duration of untreated psychosis: care pathways to early intervention in psychosis services
- Authors:
- BIRCHWOOD Max, et al
- Journal article citation:
- British Journal of Psychiatry, 203(1), 2013, pp.58-64.
- Publisher:
- Cambridge University Press
Interventions to reduce treatment delay in first-episode psychosis have met with mixed results. Systematic reviews highlight the need for greater understanding of delays within the care pathway if successful strategies are to be developed. This study documents the care-pathway components of duration of untreated psychosis (DUP) and their link with delays in accessing specialised early intervention services (EIS). It also models the likely impact on efforts to reduce DUP of targeted changes in the care pathway. Data for 343 individuals from the Birmingham, UK, lead site of the National EDEN cohort study were analysed. A third of the cohort had a DUP exceeding 6 months. The greatest contribution to DUP for the whole cohort came from delays within mental health services, followed by help-seeking delays. It was found that delay in reaching EIS was strongly correlated with longer DUP. It is concluded that community education and awareness campaigns to reduce DUP may be constrained by later delays within mental health services, especially access to EIS. (Edited publisher abstract)
Pathways to emotional dysfunction in first-episode psychosis
- Author:
- BIRCHWOOD Max
- Journal article citation:
- British Journal of Psychiatry, 182(5), May 2003, pp.373-375.
- Publisher:
- Cambridge University Press
Emotional dysfunction is pervasive even in non-affective psychosis. Sometimes (and unhelpfully) referred to as 'comorbidity', these disorders include depression, usually accompanied by hopelessness and suicidal thinking; social anxiety, usually accompanied by social avoidance and problems in forming relationships; and traumatic symptoms (post-traumatic stress disorder, PTSD). There is also the distress (fear, anger, shame) attached to the experience of psychotic symptoms.