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Association of treatment delay, migration and urbanicity in psychosis

Published online by Cambridge University Press:  15 April 2020

N. Boonstra ,
B. Sterk ,
L. Wunderink ,
S. Sytema ,
L. De Haan  and
D. Wiersma
N. Boonstra*
Affiliation:
Friesland Mental Health Care Service, Department of Education and Research, PO Box 932, 8901Leeuwarden, The Netherlands Academic Medical Center, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, Room PA3-129, 1105AZ Amsterdam, The Netherlands NHL University of Applied Science, Institute of Healthcare and Welfare Studies, Leeuwarden, The Netherlands
B. Sterk
Affiliation:
Academic Medical Center, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, Room PA3-129, 1105AZ Amsterdam, The Netherlands
L. Wunderink
Affiliation:
Friesland Mental Health Care Service, Department of Education and Research, PO Box 932, 8901Leeuwarden, The Netherlands
S. Sytema
Affiliation:
Department of psychiatry (CC72), University Center of Psychiatry, University Medical Centre Groningen, University Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
L. De Haan
Affiliation:
Academic Medical Center, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, Room PA3-129, 1105AZ Amsterdam, The Netherlands
D. Wiersma
Affiliation:
Department of psychiatry (CC72), University Center of Psychiatry, University Medical Centre Groningen, University Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
*
*Corresponding author. Tel.: +3158 284 8989; fax: +3158 284 8040. E-mail address:[email protected] (N. Boonstra).
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Abstract

Background

Several factors may contribute to duration of untreated psychosis (DUP): patient-delay, referral-delay and treatment-delay caused by mental health care services (MHS-delay). In order to find the most effective interventions to reduce DUP, it is important to know what factors in these pathways to care contribute to DUP.

Aim

To examine the relationship of the constituents of treatment delay, migration status and urbanicity.

Method

In first episode psychotic patients (n = 182) from rural, urban and highly urbanized areas, DUP, migration status and pathways to care were determined.

Results

Mean DUP was 53.6 weeks (median 8.9, SD=116.8). Patient-delay was significantly longer for patients from highly urbanized areas and for first generation immigrants. MHS-delay was longer for patients who were treated already by MHS for other diagnoses.

Conclusions

Specific interventions are needed focusing on patients living in highly urbanized areas and first generation immigrants in order to shorten patient delay. MHS should improve early detection of psychosis in patients already in treatment for other diagnosis.

Keywords

Treatment delayDUPEarly interventionMigrationFirst episodeUrbanicity
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 7 , October 2012 , pp. 500 - 505
Copyright
Copyright © European Psychiatric Association 2012

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Footnotes

1

These two authors contributed equally to this work and are joined first authors.

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