Duration of Untreated Psychosis in Chinese and Mauritian: Impact of Clinical Characteristics and Patients’ and Families’ Perspectives on Psychosis

Abstract

BackgroundDuration of untreated psychosis (DUP) is a potentially modifiable prognostic factor of course and prognosis of psychiatric disorders. Few studies have demonstrated that different cultural backgrounds or perspectives on psychosis may be important factors to the DUP. This study attempted to explore whether the DUP was different in Chinese and Mauritians and to clarify potential influencing factors to a long DUP (>3 months).Methods200 patients from China and 100 patients from Mauritius were enrolled in the study. Their respective family members were also recruited. Demographic and clinical characteristics were collected, and the Internalized Stigma of Mental Illness (ISMI) scale was adapted to measure the stigma in all subjects. Binary logistic regression analysis was used to find the potential influencing factors to the long DUP.Results35.3% of the enrolled patients had a long DUP. No significant difference was found in frequency of long DUP between the two countries. Chinese patients had relatively less perceptions of stigma. Furthermore, Chinese patients with a long DUP had more perception of breakup due to mental illness (OR = 2.22, p = 0.04) and more families’ perception of the patient being disinherited due to mental illness (OR = 6.47, p = 0.01). Mauritian patients with a long DUP were less likely to have high monthly income (OR = 0.12, p<0.01), while they had less patients’ awareness of mental illness (OR = 0.31, p<0.05) and less families’ awareness of mental illness (OR = 0.14, p<0.01).ConclusionThe results of this study underlined the importance of DUP in economic conditions, racial and sociocultural factors, and public awareness on psychosis in developing countries.

Effects of socio‐demographic characteristics, premorbid functioning, and insight on duration of untreated psychosis in first‐episode schizophrenia or schizophreniform disorder in Northern Malawi

“…This idea was also used in other previous studies (Addington et al, ; Qin et al, ; Ran et al, ). Moreover, some studies found median DUP of 2 months (Kalla et al, ; Qiu et al, ; Schimmelmann et al, ), and 4 months (O'Donoghue et al, ); while other studies dichotomized DUP using the cut‐off point of 3 (Cotter, Zabel, French, & Yung, ; Devi Thakoor et al, ; González‐Valderrama et al, ). Thus, the cut‐off points of 2, 3, and 4 months were also considered in this study in order to see if results could be maintained.…”

Is early management of psychosis designed for migrants? Improving transcultural variable collection when measuring duration of untreated psychosis

“…In Singapore, after adjustment, median and 75th percentile DUP were significantly higher among individuals of Indian compared with Chinese ethnicity (Basu, Subramaniam, Abdin, Poon, & Verma, 2015), whereas in Malaysia, DUP was longer for both Chinese and Indians than for indigenous people (Chee, Muhammad Dain, Abdul Aziz, & Abdullah, 2010). In a study conducted in China and Mauritius, the DUP did not differ between these populations, but there appeared to be less of a perception of stigma among the Chinese patients (Devi Thakoor et al, 2016). Two studies did not show differences in DUP between ethnic groups (Archie et al, 2010;Chong, Mythily, Lum, Chan, & McGorry, 2005).…”

“…Others examined DUP and socio-demographic factors (Apeldoorn et al, 2014;Burns & Kirkbride, 2012;Chee, Muhammad Dain, Abdul Aziz, & Abdullah, 2010;Hui et al, 2015;Valmaggia et al, 2015), DUP and pathways to care (Bhui, Ullrich, & Coid, 2014;Chong, Mythily, Lum, Chan, & McGorry, 2005), DUP and help-seeking (Bechard-Evans et al, 2007) or DUP and treatment delay (Boonstra et al, 2012;Morgan et al, 2005;Morgan et al, 2006), with at least 1 transcultural variable as a covariate in the analysis. One study explored DUP in populations in 2 different countries (Devi Thakoor et al, 2016).…”

“…Some studies explicitly considered transcultural factors, such as birthplace, ethnicity or race, in their study design, as shown in Table 2, either in their assessment of the population (by team discussion and consensus) (Basu, Subramaniam, Abdin, Poon, & Verma, 2015;Bhui, Ullrich, & Coid, 2014;Morgan et al, 2005Morgan et al, , 2006 or by including relevant data (Burns & Kirkbride, 2012;Devi Thakoor et al, 2016).…”

Duration of Untreated Psychosis (Dup) and Pre-Morbid Functioning, May Predict Clinical Presentation in First Episode of Psychosis (Fep): North-East Indian Study

“…26 Economic conditions, racial and sociocultural factors, and public awareness on psychosis in developing countries also affect DUP. 27 Thus, DUP is a complex and multifaceted phenomenon that is associated with early-course illness development. 28 There is significant positive correlation between mean PAS scores and duration of untreated psychosis in affective psychosis (r= 0.646, p= 0.003) and there is no significant correlation between mean PAS scores and DUP in nonaffective psychosis (r= 0.395, p= 0.051) ( Table. 5a and 5b).…”