Pathways to care of first-admitted subjects with psychosis in South-Western France.
BACKGROUND
A limited number of studies have assessed the pathways to care of patients with first-episode psychosis. The aim of the study was to describe the pathways to care of subjects with psychosis between onset of psychosis and first admission, and to examine the demographic and clinical factors influencing access to care.


METHODS
Number and type of helping contacts since onset of first psychotic symptoms were assessed using multiple sources of information in 86 subjects with psychosis first-admitted in two hospitals of South-Western France. Characteristics independently associated with long delays between onset of symptoms and first helping contact, first treatment and first admission were explored using logistic regressions.


RESULTS
Twelve per cent of subjects were first admitted without any previous helping contact. The patients were seen by a median of two helpers (maximum 7). For most patients (70%), the first helping contact was a health care professional, and the same proportion of patients had a first contact with a GP or a psychiatrist. The type of first contact was not predicted by demographic or clinical characteristics. Subjects with poor pre-morbid functioning or at-risk behaviour were more likely to have a delayed access to care.


CONCLUSIONS
The delay in access to care may not be totally attributed to inadequate management by health professionals, but may be a characteristic of the disease itself, at least in part independent of the organization of the health system.
IFR 99 of Public Health, Université Victor Segalen Bordeaux 2 and Hôpital Charles Perrens, Bordeaux, France.
A
A
Cougnard
E
E
Kalmi
A
A
Desage
D
D
Misdrahi
F
F
Abalan
H
H
Brun-Rousseau
L R
LR
Salmi
H
H
Verdoux
D000293:Adolescent; D000328:Adult; D002391:Catchment Area, Health; D005260:Female; D005602:France / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010343:Patient Admission / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000534:rehabilitation*; D011619:Psychotropic Drugs / Q000627:therapeutic use
D011619:Psychotropic Drugs