The key to reducing duration of untreated first psychosis: information campaigns.
The TIPS early intervention program reduced the duration of untreated psychosis (DUP) in first-episode schizophrenia from 16 to 5 weeks in a health care sector using a combination of easy access detection teams (DTs) and a massive information campaign (IC) about the signs and symptoms of psychosis. This study reports what happens to DUP and presenting schizophrenia in the same health care sector when the IC is stopped.


METHODS
Using an historical control design, we compare 2 cohorts of patients with first-episode Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, non-affective psychosis at admission to treatment. The first cohort (N = 108) was recruited from January 1997 to December 2000, using an IC to raise awareness about recognizing psychosis to the public, the schools, and to general practitioners. The second cohort (N = 75) was recruited from January 2002 to June 2004 with no-IC. Easy access DTs were available to both cohorts.


RESULTS
In the no-IC period, DUP increased back up to 15 weeks (median) and fewer patients came to clinical attention through the DTs. No-IC patients were diagnosed less frequently with schizophreniform disorder, more Positive and Negative Syndrome Scale positive and total symptoms, and poorer Global Assessment of Functioning (symptom) Scale scores.


CONCLUSIONS
Intensive education campaigns toward the general public, the schools, and the primary health care services appear to be an important and necessary part of an early detection program. When such a campaign was stopped, there was a clear regressive change in help-seeking behavior with an increase in DUP and baseline symptoms.
Joa
Inge
I
Stavanger University Hospital, Regional Centre for Clinical Research in Psychosis, Psychiatric Clinic, Stavanger, Norway. ijo@sus.no
Johannessen
Jan Olav
JO
Auestad
Bjørn
B
Friis
Svein
S
McGlashan
Thomas
T
Melle
Ingrid
I
Opjordsmoen
Stein
S
Simonsen
Erik
E
Vaglum
Per
P
Larsen
Tor K
TK
D000328:Adult; D000339:Affect; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D005260:Female; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D033181:Information Dissemination; D008297:Male; D016730:Program Development; D011618:Psychotic Disorders / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors