Duration of untreated psychosis: a critical examination of the concept and its importance

Norman, Ross; Malla, Ashok

doi:10.1017/s0033291701003488

Cited by 440 publications

(380 citation statements)

References 71 publications

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“…Notwithstanding this issue, the current findings suggest that the significance of minimising the duration of untreated psychosis (DUP) in first episode psychosis Norman and Malla, 2001;Norman et al, 2005), as recently observed again in the RAISE study (Kane et al, 2015), may also be critical in the UHR population in the form of minimising the duration of untreated illness (DUI). That is, identifying and providing intervention as early as possible in the course of attenuated psychotic symptoms may have an impact on the trajectory of illness, averting the transition to fullyfledged psychotic disorder.…”

Section: Discussionmentioning

confidence: 62%

Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention

Nelson

Yuen

Lin

et al. 2016

Schizophrenia Research

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Section: Discussionmentioning

confidence: 62%

Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention

Nelson

Yuen

Lin

et al. 2016

Schizophrenia Research

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“…There are at least two clinical reasons to emphasize early detection of schizophrenia: the growing evidence that by intervening in the early stages of psychosis, clinicians may be able to improve longer-term outcomes [3][4][5], and the equally important idea that early detection can result in an immediate reduction of suffering, regardless of any effects further downstream. Unfortunately, people experiencing early psychotic symptoms rarely seek treatment on their own.…”

Section: Introductionmentioning

confidence: 99%

The period of untreated psychosis before treatment initiation:

Bergner

Leiner

Carter

et al. 2008

Comprehensive Psychiatry

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Aim-This study employed a qualitative research methodology to explore common themes pertaining to the period of untreated psychosis prior to treatment initiation in hospitalized, urban, African American, first-episode psychosis patients.Methods-Twelve family members of 10 patients were interviewed at length to gather detailed narrative accounts of factors related untreated psychosis and treatment delay. Using qualitative analysis, verbatim transcripts were reviewed by two researchers to identify prominent themes useful for generating future research hypotheses.Results-Four themes emerged as informative of the period of untreated psychosis prior to treatment initiation: (1) misattribution of symptoms or problem behaviors (e.g., depression, drug use, adolescent rebellion), (2) positive symptoms causing unusual or dangerous behaviors that served as a catalyst for initiating treatment, (3) views about personal autonomy of an adult or nearly adult patient, and (4) system-level factors (e.g., unaffordability of healthcare, inefficiency on the part of healthcare providers).Conclusions-Family members encountered numerous barriers when seeking treatment, including their own misattributions, the nature of the patient's symptoms, financial issues, and system-level delays. The themes uncovered in this formative analysis merit further exploration with additional qualitative and quantitative research.

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“…Two recent strands of evidence have concentrated attention on pathways to care in psychosis: one that certain ethnic groups experience adverse pathways into care (Bhui et al, 2003), (Morgan et al, 2005, Morgan et al, 2005b and second, that reducing treatment delays may improve outcomes in early psychosis (Norman and Malla, 2001). Early intervention strategy is based upon the presupposition that at least some reasons for treatment delay are malleable and could be targeted for intervention.…”

Section: Introductionmentioning

confidence: 99%

Measuring pathways to care in first-episode psychosis: A systematic review

Singh

Grange

2006

Schizophrenia Research

120

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Background: Adequately measuring pathways to care is a prerequisite for early detection and effective treatment of first-episode psychosis. Method:We conducted a systematic review of studies on pathways to care in firstepisode psychosis to establish what measures currently exist to assess pathways in first-episode psychosis and to compare these measures. Results:We identified 15 studies which had used six different measures of pathways to care. Differences in aims, methodology and lack of psychometric data did not allow a direct comparison of pathways measures but certain common themes emerged.Discussion: Pathways to care in first-episode psychosis are diverse and varied. There is no measure with established psychometric properties that has been devised on a well-developed theoretical or conceptual framework and had its psychometric properties established. The conflict between exploring the patient"s narrative and journey through the healthcare system and developing an empirical measure of pathways with optimal outcomes has hindered the development of such a measure.

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Duration of untreated psychosis: a critical examination of the concept and its importance

Abstract: It is important that there should be more thorough investigations of DUP, its correlates, and the extent to which it does mediate any advantages of earlier intervention.

Cited by 440 publications

References 71 publications

Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention

Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention

The period of untreated psychosis before treatment initiation:

Measuring pathways to care in first-episode psychosis: A systematic review

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