Biomaterial Database

The impact of mode of onset of psychosis on pathways to care in a hospitalized, predominantly African-American, first-episode sample. 2008

Victoria H Chien, and Michael T Compton

Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia 30303, USA.

OBJECTIVE Given recent findings that mode of onset is a determinant of duration of untreated psychosis (DUP), along with a dearth of research coupling the mode of onset and pathways to care constructs, this study explored the possible effects of mode of onset on pathways to care. METHODS The study included 76 patients hospitalized for first-episode, nonaffective psychosis in two urban, public-sector psychiatric units. Consensus-based best estimates were derived for mode of onset, pathways to care variables and DUP. Associations between mode of onset and several types of pathways to care variables were examined: (i) two key duration variables during the pathway; (ii) four variables pertaining to services contacted, sources of help and reasons for psychiatric contact; and (iii) the number of help-seeking contacts during the pathway. RESULTS None of the sociodemographic or clinical variables examined (except DUP) were associated with mode of onset. In further assessing the association between mode of onset and DUP, mode of onset was related to the first component of DUP - delay in initiating any help contact - but not with the duration from initiating the first help contact until hospitalization. Mode of onset was not significantly associated with a number of other key pathways to care variables (e.g. type of first help-seeking contact, number of help-seeking contacts). CONCLUSIONS The present findings suggest that both community-wide informational campaigns and early intervention programmes may benefit from focusing on gradually developing psychosis, which confers a longer delay to initiating care.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D010342	Patient Acceptance of Health Care	Patients' willingness to receive health care.	Acceptability of Health Care,Health Care Seeking Behavior,Acceptability of Healthcare,Acceptors of Health Care,Health Care Utilization,Nonacceptors of Health Care,Patient Acceptance of Healthcare,Care Acceptor, Health,Care Acceptors, Health,Care Nonacceptor, Health,Care Nonacceptors, Health,Health Care Acceptability,Health Care Acceptor,Health Care Acceptors,Health Care Nonacceptor,Health Care Nonacceptors,Healthcare Acceptabilities,Healthcare Acceptability,Healthcare Patient Acceptance,Healthcare Patient Acceptances,Utilization, Health Care
D011618	Psychotic Disorders	Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994)	Psychoses,Psychosis, Brief Reactive,Schizoaffective Disorder,Schizophreniform Disorders,Psychosis,Brief Reactive Psychoses,Brief Reactive Psychosis,Disorder, Psychotic,Disorder, Schizoaffective,Disorder, Schizophreniform,Disorders, Psychotic,Disorders, Schizoaffective,Disorders, Schizophreniform,Psychoses, Brief Reactive,Psychotic Disorder,Reactive Psychoses, Brief,Reactive Psychosis, Brief,Schizoaffective Disorders,Schizophreniform Disorder
D001741	Black or African American	A person having origins in any of the black racial groups of Africa (https://www.federalregister.gov/documents/1997/10/30/97-28653/revisions-to-the-standards-for-the classification-of-federal-data-on-race-and-ethnicity). In the United States it is used for classification of federal government data on race and ethnicity. Race and ethnicity terms are self-identified social construct and may include terms outdated and offensive in MeSH to assist users who are interested in retrieving comprehensive search results for studies such as in longitudinal studies.	African American,African Americans,African-American,Afro-American,Afro-Americans,Black Americans,Blacks,Negroes,African-Americans,Negro,Afro American,Afro Americans,American, African,American, Black,Black American
D005260	Female		Females
D006760	Hospitalization	The confinement of a patient in a hospital.	Hospitalizations
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013997	Time Factors	Elements of limited time intervals, contributing to particular results or situations.	Time Series,Factor, Time,Time Factor
D016009	Chi-Square Distribution	A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.	Chi-Square Test,Chi Square Distribution,Chi Square Test,Chi-Square Distributions,Chi-Square Tests,Distribution, Chi-Square,Distributions, Chi-Square,Test, Chi-Square,Tests, Chi-Square
D017668	Age of Onset	The age, developmental stage, or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual.	Age-at-Onset,Age at Onset,Onset Age