Untreated psychosis duration linked to age, gender and immigration status

By Laura Cowen, medwireNews Reporter

First-generation immigrants, men and younger patients are at risk of treatment delays for first-episode psychosis, study findings indicate.

Educational level, premorbid adjustment and being a second-generation immigrant were not, however, associated with duration of untreated psychosis (DUP), report S Apeldoorn (University of Groningen, the Netherlands) and colleagues in Schizophrenia Research.

They found that the median DUP was less than 1 month (range <1–226 months) among the 852 patients with a non-affective psychotic disorder who were recruited to the study from mental healthcare institutes in the Netherlands and Belgium.

This is short compared with the average median DUP of 26 weeks reported in most international studies, the researchers note, but is in line with other recently published Dutch studies.

Logistic regression analysis showed that women were 35% less likely to have a longer DUP than men, which was “not expected” because results of a previously published review did not confirm an association between DUP and gender, Apeldoorn et al remark.

This finding suggests that “the process involved in men’s help seeking behaviour deserves attention”, they say.

The regression analysis also showed that first-generation immigrants were 1.74 times more likely to have a longer DUP than native patients. This finding “may be of major importance in countries like the Netherlands, where immigrants constitute more than one fifth of the population”, the authors note.

They add that the association may be due to the fact that first-generation immigrants are less familiar with mental illness and mental health services or are more reluctant to admit they have a psychiatric problem that requires treatment. Language barriers may also play a part, say the researchers who go on to suggest that future research should look for interventions that may shorten DUP in first-generation immigrants.

Finally, the team found that younger age at onset was associated with longer DUP. However, they point out that the odds ratio was very close to 1 (0.96), indicating that, although statistically significant, age at onset may not actually be a clinically relevant risk factor in DUP.

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