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European Psychiatry
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le samedi 25 juin 2011
Doi : 10.1016/j.eurpsy.2011.05.001
Received : 21 December 2010 ;  accepted : 9 May 2011
Association of treatment delay, migration and urbanicity in psychosis
 

N. Boonstra a, ⁎, b, d, 1 , B. Sterk b, 1, L. Wunderink a, S. Sytema c, L. De Haan b, D. Wiersma c
a Friesland Mental Health Care Service, Department of Education and Research, PO Box 932, 8901 Leeuwarden, The Netherlands 
b Academic Medical Center, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, Room PA3-129, 1105 AZ Amsterdam, The Netherlands 
c Department of psychiatry (CC72), University Center of Psychiatry, University Medical Centre Groningen, University Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands 
d NHL University of Applied Science, Institute of Healthcare and Welfare Studies, Leeuwarden, The Netherlands 

Corresponding author. Tel.: +3158 284 8989; fax: +3158 284 8040.
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 delay, DUP, Early intervention, Migration, First episode, Urbanicity


OutlineMasquer le plan
Introduction
Materials and methods  (+)
Results  (+)
Discussion  (+)
Disclosure of interest
1  These two authors contributed equally to this work and are joined first authors.


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