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First episode schizophrenia in general practice: a national survey

Published online by Cambridge University Press:  13 June 2014

Blanaid Gavin
Affiliation:
St John of God Hospital, Stillorgan Co Dublin, Ireland
Walter Cullen
Affiliation:
Department of General Practice, University College Dublin, Dublin 4, Ireland
Brian O'Donoghue
Affiliation:
Department of General Practice and Department of Psychiatry, University College Dublin, Dublin 4, Ireland
Juan Carlos Ascencio-Lane
Affiliation:
Department of General Practice and Department of Psychiatry, University College Dublin, Dublin 4, Ireland
Gerard Bury
Affiliation:
DELTA/DETECT, Early Intervention in Psychosis Service, 1 Marine Tee, Dun Laoghaire, Co Dublin, Ireland
Eadbhard O'Callaghan
Affiliation:
Hospital Order of St John of God, Cluain Mhuire Service, Newtownpark Avenue, Blackrock, and DELTA/DETECT, Early Intervention in Psychosis Service, 1 Marine Tee, Dun Laoghaire, Co Dublin, Ireland

Abstract

Objective: We sought to establish the views of general practitioners about detecting and managing patients with a first episode of schizophrenia in Ireland.

Method: Twenty per cent of GPs were invited to participate in a cross-sectional postal survey.

Results: Sixty-two per cent (n = 261) participated. Almost all (99.2%) see at least one case of suspected first episode schizophrenia annually. The most commonly (80.7%) encountered symptom is ‘bizarre behaviour’. Many (47.7%) rarely or never prescribe antipsychotics to patients whom they suspect have a first episode of schizophrenia. However, 80.6% of GPs reported that they ‘always’ refer this group of patients to psychiatric services. Over half (57.8%) advised patients with schizophrenia to continue medication for less than a year. A large number of respondents reported that it is difficult to obtain a rapid psychiatric assessment.

Conclusions: GPs want more information about identifying early psychosis, a closer liaison with psychiatric services and a rapid intervention service.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2006

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References

1.Birchwood, M, Todd, P, & Jackson, C. Early intervention in psychosis. The critical period hypothesis. Br J Psychiatry 1998; 172 (33): 5359.CrossRefGoogle ScholarPubMed
2.Clarke, M, O'Callaghan, E. Is earlier better? At the beginning of schizophrenia: timing and opportunities for early intervention. Psychiatric Clinics of North America 2003; 26(1): 6583.CrossRefGoogle ScholarPubMed
3.Johnstone, E. MacMillan, FJ, Frith, CDet al. Further investigation of the predictors of outcome following first schizophrenic episodes. Br J Psychiatry 1990; 157: 182–9.CrossRefGoogle ScholarPubMed
4.Scully, PJ, Coakley, G, Kinsella, A, et al.Psychopathology, executive function and general cognitive impairment in relation to duration of initially untreated versus subsequent treated psychosis in chronic schizophrenia. Psychol Med 1997; 27: 1303–10.CrossRefGoogle ScholarPubMed
5.Kamali, M, Kelly, L, Gervin, M, Browne, S, Larkin, C, O'Callaghan, E. The prevalence of comorbid substance misuse and its influence on suicidal ideation among inpatients with schizophrenia. Acta Psychiatr Scand 2000; 101 (6): 452–56.CrossRefGoogle ScholarPubMed
6.Davies, LM, Drummond, MF. Economics and schizophrenia: the real cost. Br J Psychiatry Suppl 1994; 1821.CrossRefGoogle ScholarPubMed
7.Simon, AE, Umbricht, D, Merlo, MCG. Swiss general practitioners and first episode psychoses: Results of a National Survey. Schizophrenia Research 2002; 53(3): 15.Google Scholar
8.Kendrick, T, Burns, T. Mental health teams should concentrate on psychiatric patients with greatest needs. BMJ 1996; 313: 884–5.CrossRefGoogle ScholarPubMed
9.Johnstone, EC, Crow, TJ, Johnson, AL, MacMillan, JF. The Northwick Park Study of first episodes of schizophrenia I. Presentation of the illness and problems relating to admission. Br J Psychiatry 1986; 148: 115–20.CrossRefGoogle ScholarPubMed
10.Goldberg, D, Jackson, G. Interface between primary care and specialist mental health care. Br J Gen Practice 1992; 42: 267–69.Google ScholarPubMed
11.Lincoln, C, Harrigan, S, McGorry, PD. Understanding the topography of the early psychosis pathways. An opportunity to reduce delays in treatment. Br J Psychiatry 1998; 172(33): 21–5.CrossRefGoogle ScholarPubMed
12.Harrigan, SM, McGorry, PD, Krstev, H. Does treatment delay in first-episode psychosis really matter? Psychol Med 2003; 33(1): 97110.CrossRefGoogle ScholarPubMed
13.McGlashan, TH, Johannessen, JO. Early detection and intervention with schizophrenia: rationale. Schizophr Bull 1996; 22: 201222.CrossRefGoogle ScholarPubMed
14.Drake, RJ, Haley, CJ, Akhtar, S, Lewis, SW. Causes and consequences of duration of untreated psychosis in schizophrenia. Br J Psychiatry 2000; 177: 511–15.CrossRefGoogle ScholarPubMed
15.Browne, S, Clarke, M, Gervin, M, Waddington, JL, Larkin, C, O'Callaghan, E. Determinants of quality of life at first presentation with schizophrenia. Br J Psychiatry 2000; 176: 173–6.CrossRefGoogle ScholarPubMed
16.Tennakoon, LA, Fannoon, D, Doku, V, et al.Experience of care giving: relatives of people experiencing a first episode of psychosis. Br J Psychiatry 2000; 177: 529–33.CrossRefGoogle Scholar
17.Melle, I, Larsen, TK, Haahr, U, Friis, S, et al. Reducing the duration of untreated first-episode psychosis: effects on clinical presentation. Arch Gen Psychiatry 2004; 61 (2): 143–50.CrossRefGoogle ScholarPubMed