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Pathways to care for first-episode psychosis in an early detection healthcare sector

Part of the Scandinavian TIPS study^*

Division of Psychiatry, General Hospital of Rogaland, Stavanger

INGRID MELLE, MD, SVEIN FRIIS, MD and STEIN OPJORDSMOEN, MD

Ullevål University Hospital, Oslo

BJØRN RISHOVD RUND, PhD

Institute of Psychology, University of Oslo, Norway

ERIK SIMONSEN, MD

Roskilde Psychiatric University Hospital Fjorden, Roskilde, Denmark

PER VAGLUM, MD

Department of Behavioural Sciences in Medicine, University of Oslo, Norway

THOMAS H. McGLASHAN, MD

Yale University School of Medicine, New Haven, Connecticut, USA

Correspondence: Dr Jan Olav Johannessen, Division of Psychiatry, General Hospital of Rogaland, Armauer Hanssens vei 20,4000 Stavanger Norway.E-mail: jojo{at}sir.no

Declaration of interest Supporters included Lundbeck Pharma, Eli Lilly and Janssen-Cilag Pharmaceuticals; full details in Acknowledgements.

^* Paper presented at the Third International Early Psychosis Conference, Copenhagen, Denmark, September 2002.

Background Early detection programmes aim to reduce the duration of untreated psychosis (DUP) by public education and by prompt access to treatment via active outreach detection teams.

Aims To determine whether those with first-episode psychosis in an early detection healthcare area with existing referral channels differ from those who access care via detection teams.

Method Those with first-episode psychosis recruited via detection teams were compared with those accessing treatment via conventional channels, at baseline and after 3 months of acute treatment.

Results Patients recruited via detection teams are younger males with a longer DUP, a less dramatic symptom picture and better functioning; however they recover more slowly, and have more symptoms at 3-month follow-up.

Conclusions After establishing low threshold active case-seeking detection teams, we found clear differences between those patients entering treatment via detection teams v. those obtaining treatment via the usual channels. Such profiling may be informative for early detection service development.

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