Hostname: page-component-848d4c4894-x5gtn Total loading time: 0 Render date: 2024-05-01T11:17:43.863Z Has data issue: false hasContentIssue false
  • English
  • Français

First-episode schizophrenia with long duration of untreated psychosis: Pathways to care

Published online by Cambridge University Press:  06 August 2018

Tor K. Larsen ,
Jan Olav Johannessen  and
Stein Opjordsmoen
Tor K. Larsen*
Affiliation:
Rogland Psychiatric Hospital, Sandnes/Stavanger, Norway
Jan Olav Johannessen
Affiliation:
Rogland Psychiatric Hospital, Sandnes/Stavanger, Norway
Stein Opjordsmoen
Affiliation:
Department of Psychiatry, Ullevål Hospital, Oslo, Norway
*
Correspondence: Tor K. Larsen, Psychiatric Hospital of Rogaland, Armauer Hansensv, 20 4011 Stavanger, Norway. Fax: 51 51 99 09
Get access Rights & Permissions [Opens in a new window]

Abstract

Background The early course of illness in first-episode schizophrenia was examined with special emphasis on the duration of untreated psychosis and pathways to care.

Method The consecutively admitted individuals (n=34) were assessed on premorbid functioning, duration of untreated psychosis, global functioning, symptoms and social network. To clarify the obstacles for receiving earlier treatment, 17 case histories with long duration of untreated psychosis were intensively studied.

Results The duration of untreated psychosis was on average very long (130 weeks), the median value was 54 weeks. The long duration of untreated psychosis group (> 54 weeks) had greater deterioration in the premorbid phase, a weaker social network and were more withdrawn than the short duration of untreated psychosis group (< 54 weeks). The main obstacles for receiving treatment were withdrawal and poor social network.

Conclusions In order to identify people earlier, a system of detection must be mobile, easily accessible and attentive to early symptoms of psychosis. It seems to be important to educate the social network related to the individual about the importance of early treatment.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 172 , Issue S33: Verging on reality , June 1998 , pp. 45 - 52
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amador, X. F., Flaum, M., Andreasen, N., et al (1994) Awareness of illness in schizophrenia and schizoaffective and mood disorders. Archives of General Psychiatry, 51, 826–836.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Beiser, M., Erickson, D., Fleming, J. A. E., et al (1993) Establishing the onset of psychotic illness. American Journal of Psychiatry, 150, 1349–1354.Google ScholarPubMed
Cannoon-Spoor, H. E., Potkin, S. G. & Wyatt, R. J. (1982) Measurement of premorbid adjustment in chronic schizophrenia. Schizophrenia bulletin, 8, 470–484.Google Scholar
Falloon, I. R. H. (1985) Family Management of Schizophrenia. Baltimore, MD: Johns Hopkins University Press.Google Scholar
Falloon, I. R. H., Kydd, R. R., Coverdale, H. J., et al (1996) Early detection and intervention for initial episodes of schizophrenia. Schizophrenia bulletin, 22, 271–282.Google Scholar
Goldfinger, S. M. (1990) Perspectives on the homeless mentally ill. Community Mental Health Journal, 26, 387–390.Google Scholar
Haas, G. L. & Sweeney, J. A. (1992) Premorbid and onset features of first episode schizophrenia. Schizophrenia Bulletin, 18, 373–386.CrossRefGoogle ScholarPubMed
Haefner, H., Maurer, K., Loeffler, W., et al (1993) The influence of age and sex on the onset of early course of schizophrenia. British Journal of Psychiatry, 162, 80–86.Google Scholar
Helgason, L. (1990) Twenty years’ follow-up of first psychiatric presentation for schizophrenia: what could have been prevented? Acta Psychiatrica Scandinavica, 81, 231–235.Google Scholar
Herz, M. (1985) Prodromal symptoms and prevention of relapse in schizophrenia. Journal of Clinical Psychiatry, 46, 22–25.Google Scholar
Johnstone, E. C., MacMillan, J., Crow, T., et al (1986) The Northwich Park first episodes of schizophrenia. III. Short-term outcome in trial entrants and trial eligible patients. British Journal of Psychiatry, 148, 128–133.Google Scholar
Kay, S. R., Fiszbein, A. & Opler, L. A. (1987) The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261–269.Google Scholar
Larsen, T. K., McGlashan, T. H. & Moe, L.C. (1996a) First-episode schizophrenia: I. Early course parameters. Schizophrenia Bulletin, 22, 241–256.CrossRefGoogle ScholarPubMed
Larsen, T. K., McGlashan, T. H., Johannessen, J. O., et al (1996b) First-episode schizophrenia: II. Premorbid patterns by gender. Schizophrenia Bulletin, 22, 257–270.Google Scholar
Leff, J., Berkowitz, R., Shavit, N., et al (1990) A trial of family therapy versus relatives’ group of schizophrenia. Two year follow-up. British Journal of Psychiatry, 157, 571–577.Google Scholar
Lieberman, J. A., Jody, D., Geisler, S., et al (1993) Time course and biologic correlates of treatment response in first-episode schizophrenia. Archives of General Psychiatry, 50, 369–376.Google Scholar
Lincoln, C. V. & McGorry, P. D. (1995) Who cares? Pathways to psychiatric care in early psychosis. Psychiatric Services, 46, 1166–1171.Google Scholar
Loebel, A. D., Lieberman, J. A., Alvir, J. M. J., et al (1992) Duration of psychosis and outcome in first-episode schizophrenia. American Journal of Psychiatry, 149, 1183–1188.Google Scholar
McGorry, P. D. (1992) The concept of recovery and secondary prevention in psychotic disorders. Australian and New Zealand Journal of Psychiatry, 26, 3–17.Google Scholar
McGorry, P. D., Edwards, J., Mihalopoulos, C., et al (1996) EPPIC: An evolving system of early detection and optimal management. Schizophrenia Bulletin, 22, 305–326.Google Scholar
McGlashan, T. H. (1996) Early detection and intervention in schizophrenia. Schizophrenia Bulletin, 22, 197–200.Google Scholar
McGlashan, T. H. & Johannessen, J. O. (1996) Early detection and intervention with schizophrenia. Schizophrenia Bulletin, 22, 201–222.CrossRefGoogle ScholarPubMed
Olin, S. S. & Mednick, S. A. (1996) Risk factors of psychosis: identifying vulnerable populations premorbidly. Schizophrenia Bulletin, 22, 223–240.CrossRefGoogle ScholarPubMed
Opjordsmoen, S. (1991) Long-term clinical outcome of schizophrenia with special reference to gender differences. Acta Psychiatrica Scandinavica, 83, 307–313.Google Scholar
Spitzer, R. L., Williams, J. B. W., Gibbon, M., et al (1990) Structured Clinical Interview for DSM–III–R, Patient edition (SCID-p). Washington, DC: APR Google Scholar
Strauss, J. S. & Carpenter, W.T. (1974) The prediction of outcome in schizophrenia. II. Relationships between predictor and outcome variables. Archives of General Psychiatry, 31, 37–42.CrossRefGoogle ScholarPubMed
Vaglum, P. (1996) Early detection and intervention in schizophrenia. Schizophrenia Bulletin, 22, 347–352.Google Scholar
Weiden, P., Rapkin, B., Mott, T., et al (1994) Rating of medication influences (ROMI) scale in schizophrenia. Schizophrenia Bulletin, 20, 297–310.CrossRefGoogle ScholarPubMed
Wyatt, R. J. (1991) Neuroleptics and the natural course of schizophrenia. Schizophrenia Bulletin, 17, 325–351.Google Scholar
Yung, A. R., McGorry, P. D., McFarlane, C. A., et al (1996) Monitoring and care of young people at incipient risk of psychosis. Schizophrenia Bulletin, 22, 283–304.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.