Duration of untreated psychosis and pathways to psychiatric services in first-episode schizophrenia
Article first published online: 17 DEC 2003
Psychiatry and Clinical Neurosciences
Volume 58, Issue 1, pages 76–81, February 2004
How to Cite
YAMAZAWA, R., MIZUNO, M., NEMOTO, T., MIURA, Y., MURAKAMI, M. and KASHIMA, H. (2004), Duration of untreated psychosis and pathways to psychiatric services in first-episode schizophrenia. Psychiatry and Clinical Neurosciences, 58: 76–81. doi: 10.1111/j.1440-1819.2004.01196.x
- Issue published online: 17 DEC 2003
- Article first published online: 17 DEC 2003
- Received 14 May 2003; revised 10 July 2003; accepted 28 July 2003.
- duration of untreated psychosis;
- first-episode psychosis;
- first-episode schizophrenia;
Abstract The aim of the present study was to examine the duration of untreated psychosis (DUP) in first-episode schizophrenia patients in Japan and to investigate the available pathways to psychiatric services. Eighty-three patients who visited Keio University Hospital (n = 54) or Oizumi Mental Hospital (n = 29) were evaluated retrospectively with regard to their DUP, living situation, social participation level, referral pathway, reason for seeking treatment, and their global assessment of functioning (GAF) score. The mean DUP was 13.7 months (median, 5.0 months) overall. No significant difference in DUP was found between subjects living alone and those living with others; however, employed patients had a significantly shorter DUP (8.1 months) than unemployed patients (18.7 months). Pathways to psychiatric services were totally different between the two institutions. Fifty-two subjects (62.7%) came to the services directly: 40 patients (74.1%) came to the university hospital and 12 patients (41.4%) came to the mental hospital. At the mental hospital, nine patients (31.0%) had been admitted because of a legal obligation, and six (20.7%) had been referred through public health centers. None of the patients had been referred to either of the services by general practitioners. The main reason for seeking treatment was psychiatric symptom aggravation (59.3%) at the university hospital and acting out (64.3%) at the mental hospital. Some universal psychosocial factors appear to influence the DUP but the characteristics of specific psychiatric services may also affect treatment delays.