Pathways to care in subjects at high risk for psychotic disorders — A European perspective

von Reventlow, Heinrich Graf; Krüger-Özgürdal, Seza; Ruhrmann, Stephan; Schultze-Lutter, Frauke; Heinz, Andreas; Patterson, Paul; Heinimaa, Markus; Dingemans, Peter; French, Paul; Birchwood, Max; Salokangas, Raimo K. R.; Linszen, Don; Morrison, Anthony; Klosterkötter, Joachim; Juckel, Georg (2014). Pathways to care in subjects at high risk for psychotic disorders — A European perspective. Schizophrenia Research, 152(2-3), pp. 400-407. Elsevier 10.1016/j.schres.2013.11.031

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Evidence-based decisions on indicated prevention in early psychosis require large-scale studies on the pathways to care in high-risk subjects. EPOS (The European Prediction of Psychosis Study), a prospective multi-center, naturalistic field study in four European countries (Finland, Germany, The Netherlands and England), was designed to acquire accurate knowledge about pathways to care and delay in obtaining specialized high risk care. Our high risk sample (n=233) reported on average 2.9 help-seeking contacts, with an average delay between onset of relevant problems to initial help-seeking contact of 72.6 weeks, and between initial help-seeking contact and reaching specialized high risk care of 110.9 weeks. This resulted in a total estimated duration of an unrecognized risk for psychosis of 3 ½ years. Across EPOS EU regions, about 90% of care pathway contacts were within professional health care sectors. Between EPOS regions, differences in the pathways parameters including early detection and health-care systems were often very pronounced. High-risk participants who later made transition to a full psychotic disorder had significantly longer delays between initial help-seeking and receiving appropriate interventions. Our study underlines the need for regionally adapted implementation of early detection and intervention programs within respective mental health and health care networks, including enhancing public awareness of early psychosis.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy > Research Division

UniBE Contributor:

Schultze-Lutter, Frauke


600 Technology > 610 Medicine & health








Nicole Jansen

Date Deposited:

02 Oct 2014 16:22

Last Modified:

11 Nov 2015 11:39

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Early psychosis High-risk Mental health care services Pathways to care




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