title: Patients' relatives delayed help seeking after a first psychotic episode.
abstract: OBJECTIVE
  Recent studies show that proper treatment after the first psychotic episode may be delayed for a long time. Some patients remain without care even while exhibiting serious symptoms. The objective of the study was to understand the reasons why patients' relatives waited at least 6 months to look for psychiatric counseling and treatment.
  
  
  METHODS
  Qualitative analyses of semi-structured interviews with 15 relatives (of patients with first psychotic episode) who have waited more than six months before seeking psychiatric treatment were applied. The interviews were recorded; transcribed and relevant portions were codified and grouped, forming terms, concepts or categories.
  
  
  RESULTS
  These family members referred to individuals with mental problems in other families in a stereotyped fashion, citing negative aspects such as violence and criminality. They used softer terms when referring to their family members. Not knowing that their sick relative to be a case of mental illness, relatives classified certain observed behaviors as coming principally from spiritual problems and drug use. The initial delay in seeking medical help for the sick person was influenced by: 1) stereotyped misconceptions used by relatives to understand mental problems; 2) explanatory models elaborated to try to understand the sick person's behavior; 3) fear of psychiatric treatment; and 4) negative experiences with psychiatric services.
  
  
  CONCLUSIONS
  Cultural aspects are present at all levels of this elaboration process. Their proper understanding by physicians can considerably diminish relatives' pain and suffering.
authors.affiliation: Department of Psychiatry, Paulista Medical School, Universidade Federal de São Paulo, São Paulo, SP, Brazil. vbmonteiro@uol.com.br
authors.forename: Vera B M
authors.initials: VB
authors.lastname: Monteiro
authors.forename: José Quirino
authors.initials: JQ
authors.lastname: dos Santos
authors.forename: Denise
authors.initials: D
authors.lastname: Martin
mesh_terms: D000328:Adult; D003466:Cultural Characteristics; D005190:Family / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*; D036301:Qualitative Research; D013997:Time Factors