PMID- 26155901
OWN - NLM
STAT- MEDLINE
DCOM- 20160318
LR  - 20181202
IS  - 1433-9285 (Electronic)
IS  - 0933-7954 (Linking)
VI  - 50
IP  - 12
DP  - 2015 Dec
TI  - Duration of unspecific prodromal and clinical high risk states, and early 
      help-seeking in first-admission psychosis patients.
PG  - 1831-41
LID - 10.1007/s00127-015-1093-3 [doi]
AB  - PURPOSE: Prevention of psychosis requires both presence of clinical high risk 
      (CHR) criteria and early help-seeking. Previous retrospective studies of the 
      duration of untreated illness (i.e. prodrome plus psychosis) did not distinguish 
      between prodromal states with and without CHR symptoms. Therefore, we examined 
      the occurrence of CHR symptoms and first help-seeking, thereby considering 
      effects of age at illness-onset. METHODS: Adult patients first admitted for 
      psychosis (n = 126) were retrospectively assessed for early course of illness and 
      characteristics of first help-seeking. RESULTS: One-hundred and nine patients 
      reported a prodrome, 58 with CHR symptoms. In patients with an early 
      illness-onset before age 18 (n = 45), duration of both illness and psychosis were 
      elongated, and CHR symptoms more frequent (68.9 vs. 33.3 %) compared to those 
      with adult illness-onset. Only 29 patients reported help-seeking in the prodrome; 
      this was mainly self-initiated, especially in patients with an early 
      illness-onset. After the onset of first psychotic symptoms, help-seeking was 
      mainly initiated by others. State- and age-independently, mental health 
      professionals were the main first point-of-call (54.0 %). CONCLUSIONS: Adult 
      first-admission psychosis patients with an early, insidious onset of symptoms 
      before age 18 were more likely to recall CHR symptoms as part of their prodrome. 
      According to current psychosis-risk criteria, these CHR symptoms, in principle, 
      would have allowed the early detection of psychosis. Furthermore, compared to 
      patients with an adult illness-onset, patients with an early illness-onset were 
      also more likely to seek help on their own account. Thus, future awareness 
      strategies to improve CHR detection might be primarily related to young persons 
      and self-perceived subtle symptoms.
FAU - Schultze-Lutter, Frauke
AU  - Schultze-Lutter F
AD  - University Hospital of Child and Adolescent Psychiatry, University of Bern, 
      Bolligenstrasse 111, Haus A, 3000, Bern 60, Switzerland. 
      frauke.schultze-lutter@kjp.unibe.ch.
FAU - Rahman, Jonas
AU  - Rahman J
AD  - University Hospital of Child and Adolescent Psychiatry, University of Bern, 
      Bolligenstrasse 111, Haus A, 3000, Bern 60, Switzerland.
FAU - Ruhrmann, Stephan
AU  - Ruhrmann S
AD  - Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, 
      Germany.
FAU - Michel, Chantal
AU  - Michel C
AD  - University Hospital of Child and Adolescent Psychiatry, University of Bern, 
      Bolligenstrasse 111, Haus A, 3000, Bern 60, Switzerland.
FAU - Schimmelmann, Benno G
AU  - Schimmelmann BG
AD  - University Hospital of Child and Adolescent Psychiatry, University of Bern, 
      Bolligenstrasse 111, Haus A, 3000, Bern 60, Switzerland.
FAU - Maier, Wolfgang
AU  - Maier W
AD  - Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
FAU - Klosterkotter, Joachim
AU  - Klosterkotter J
AD  - Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, 
      Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150709
PL  - Germany
TA  - Soc Psychiatry Psychiatr Epidemiol
JT  - Social psychiatry and psychiatric epidemiology
JID - 8804358
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Early Diagnosis
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Mental Recall
MH  - Middle Aged
MH  - Patient Acceptance of Health Care/*psychology/statistics & numerical data
MH  - Patient Admission/*statistics & numerical data
MH  - *Prodromal Symptoms
MH  - Psychotic Disorders/*psychology/*therapy
MH  - Retrospective Studies
MH  - Risk
MH  - Time Factors
MH  - Young Adult
OTO - NOTNLM
OT  - Child and adolescent psychiatry
OT  - Early intervention
OT  - First episode
OT  - Health behaviour
OT  - Psychoses
EDAT- 2015/07/15 06:00
MHDA- 2016/03/19 06:00
CRDT- 2015/07/10 06:00
PHST- 2015/04/22 00:00 [received]
PHST- 2015/06/29 00:00 [accepted]
PHST- 2015/07/10 06:00 [entrez]
PHST- 2015/07/15 06:00 [pubmed]
PHST- 2016/03/19 06:00 [medline]
AID - 10.1007/s00127-015-1093-3 [pii]
AID - 10.1007/s00127-015-1093-3 [doi]
PST - ppublish
SO  - Soc Psychiatry Psychiatr Epidemiol. 2015 Dec;50(12):1831-41. doi: 
      10.1007/s00127-015-1093-3. Epub 2015 Jul 9.