Duration of unspecific prodromal and clinical high risk states, and early help-seeking in first-admission psychosis patients

Schultze-Lutter, Frauke; Rahman, Jonas; Ruhrmann, Stephan; Michel, Chantal; Schimmelmann, Benno Karl Edgar; Maier, Wolfgang; Klosterkötter, Joachim (2015). Duration of unspecific prodromal and clinical high risk states, and early help-seeking in first-admission psychosis patients. Social psychiatry and psychiatric epidemiology, 50(12), pp. 1831-1841. Springer 10.1007/s00127-015-1093-3

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PURPOSE Prevention of psychosis requires both presence of clinical high risk (CHR) criteria and early help-seeking. Previous retrospective studies of the duration of untreated illness (i.e. prodrome plus psychosis) did not distinguish between prodromal states with and without CHR symptoms. Therefore, we examined the occurrence of CHR symptoms and first help-seeking, thereby considering effects of age at illness-onset. METHODS Adult patients first admitted for psychosis (n = 126) were retrospectively assessed for early course of illness and characteristics of first help-seeking. RESULTS One-hundred and nine patients reported a prodrome, 58 with CHR symptoms. In patients with an early illness-onset before age 18 (n = 45), duration of both illness and psychosis were elongated, and CHR symptoms more frequent (68.9 vs. 33.3 %) compared to those with adult illness-onset. Only 29 patients reported help-seeking in the prodrome; this was mainly self-initiated, especially in patients with an early illness-onset. After the onset of first psychotic symptoms, help-seeking was mainly initiated by others. State- and age-independently, mental health professionals were the main first point-of-call (54.0 %). CONCLUSIONS Adult first-admission psychosis patients with an early, insidious onset of symptoms before age 18 were more likely to recall CHR symptoms as part of their prodrome. According to current psychosis-risk criteria, these CHR symptoms, in principle, would have allowed the early detection of psychosis. Furthermore, compared to patients with an adult illness-onset, patients with an early illness-onset were also more likely to seek help on their own account. Thus, future awareness strategies to improve CHR detection might be primarily related to young persons and self-perceived subtle symptoms.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Schultze-Lutter, Frauke; Rahman, Jonas; Michel, Chantal and Schimmelmann, Benno Karl Edgar

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0933-7954

Publisher:

Springer

Language:

English

Submitter:

Nicole Jansen

Date Deposited:

04 Aug 2015 15:51

Last Modified:

21 Nov 2015 01:30

Publisher DOI:

10.1007/s00127-015-1093-3

PubMed ID:

26155901

Uncontrolled Keywords:

Child and adolescent psychiatry, Early intervention, First episode, Health behaviour, Psychoses

BORIS DOI:

10.7892/boris.70665

URI:

https://boris.unibe.ch/id/eprint/70665

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