Delay in treatment for psychosis : its relation to family history.
BACKGROUND
Recent evidence that treatment delay may compromise the potential for recovery from psychotic disorders has resulted in increased interest in factors that influence help seeking. In this paper, we test the hypotheses, derived from past research, that having a positive family history of a psychotic disorder in first or second degree relatives will be associated with a shorter duration of untreated psychosis (DUP), but a longer duration of untreated illness (DUI). Data were derived from 169 patients who presented for treatment to a first episode psychotic disorders program. Information was collected concerning family history, DUP, DUI and the timing of family recognition of the need for help.


RESULTS
The findings failed to confirm a positive family history being associated with shorter DUP, but did support the prediction of such a history being related to longer DUI. Paradoxically, given the latter findings, families with a history of psychotic illness were more likely to recognize the need for help for the ill person prior to the onset of psychotic symptoms. The difference in DUI appears to reflect the presence of a longer period of early signs prior to the emergence of psychosis in those cases with a positive family history.


CONCLUSIONS
These findings suggest the importance of examining family history as a possible confound of any relationship between DUI and long-term course of illness.
Norman
Ross M G
RM
Dept. of Psychiatry, University of Western Ontario, London (ON), Canada. rnorman@uwo.ca
Malla
Ashok K
AK
Manchanda
Rahul
R
D000328:Adult; D017028:Caregivers / Q000193:education / Q000523:psychology*; D042241:Early Diagnosis; D017050:Episode of Care; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008487:Medical History Taking; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009864:Ontario; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011379:Prognosis; D011618:Psychotic Disorders / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D012559:Schizophrenia / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome