Onset and Early Course of Schizophrenia

Häfner, Heinz; Maurer, Kurt; Löffler, W.; Bustamante, Sonia; Heiden, W. van der; Riecher‐Rössler, Anita; Nowotny, B.

doi:10.1007/978-3-642-79429-2_3

Cited by 98 publications

(84 citation statements)

References 36 publications

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“…Pathways to care are influenced by various factors such as gender, cultural and economic background or the social network of the individual [19][20][21][22][23][24]. Social withdrawal, lack of social network, belonging to an ethnic minority, being unemployed or single or having negative stereotypes about psychiatric diseases hinder help-seeking efforts [20,21,23].…”

Section: Introductionmentioning

confidence: 99%

Help-seeking and pathways to care in the early stages of psychosis

Fridgen

Aston

Gschwandtner

et al. 2012

Soc Psychiatry Psychiatr Epidemiol

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Purpose Delay in the treatment of a first psychotic episode can have a negative influence on the future course of the disease. In this context, it is important to examine pathways to care to understand factors contributing to delay in access to adequate care. Methods Using the Basel Interview for Psychosis, we examined the help-seeking behaviour of 61 individuals with an at-risk mental state for psychosis and 37 patients with a first episode of psychosis in a low threshold health care system as part of the Basel early detection of psychosis study. Results The median duration of untreated illness was 3.4 years, of untreated psychosis 12 months. Eighty-six percent of all individuals sought help of some kind before reaching our specialised early detection outpatient clinic, with a mean number of help-seeking contacts of 1.5 prior to referral. The most frequent first help-seeking contacts were family members or relatives n = 24 (26.7 %), close friends n = 17 (17.9 %), psychiatrists in private practice n = 13 (14.4 %) or general practitioners n = 11 (12.2 %). Most patients consulted other health professionals in the early course of the illness before reaching our specialised service; help-seeking with non-medical institutions was rare. Women had more help-seeking contacts than men before contact with our early detection clinic. Conclusions Family, close friends and medical professionals play an important role in help-seeking leading to specialised psychiatric care. Men seek help less often; specific strategies for encouraging young, at-risk men to seek help should be developed.

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Section: Introductionmentioning

confidence: 99%

Help-seeking and pathways to care in the early stages of psychosis

Fridgen

Aston

Gschwandtner

et al. 2012

Soc Psychiatry Psychiatr Epidemiol

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show abstract

“…But this event is determined not only by the increase in serious symptoms and impairment, but also by patients' helpseeking behaviour and the availability of adequate care. A suitable illnessrelated event to mark the end of the early illness stage is the climax of the first psychotic episode, operationalized as the maximum of positive symptoms [18]. Figure 1.1, based on data from the ABC Schizophrenia Study, depicts the mean durations (and medians) of the intervals between the milestones or stages of evolving schizophrenia.…”

Section: Defining and Operationalizing The Prodromal Stage And The MImentioning

confidence: 99%

“…In this context it should be kept in mind, as mentioned above, that in the first psychotic episode also unspecific and negative symptoms increase simultaneously with positive symptoms [18]. The aim of early intervention is not only to reduce the most enduring component of the illness, but also to try to reduce or even prevent the early social consequences, which decisively co-determine the social course of the disorder and the kind of life patients will be able to lead.…”

Section: ______________ Early Detection and Management Of Mental Disomentioning

confidence: 99%

“…As retrospective analyses have shown [18], they tend to emerge long before psychosis onset (see Table 1.1). Negative symptoms manifest themselves before and simultaneously with positive symptoms and reach a maximum at the climax of the psychotic episode.…”

Section: Assessing Prodromal Symptoms and Impairment In The Early Coumentioning

confidence: 99%

“…Negative symptoms manifest themselves before and simultaneously with positive symptoms and reach a maximum at the climax of the psychotic episode. As the psychosis remits, they too remit fully or in part [18]. In the further illness course, their prevalence shows a plateau [99].…”

Section: Assessing Prodromal Symptoms and Impairment In The Early Coumentioning

confidence: 99%

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