The period of untreated psychosis before treatment initiation: a qualitative study of family members' perspectives.
OBJECTIVE
This study used a qualitative research methodology to explore common themes pertaining to the period of untreated psychosis before treatment initiation in hospitalized, urban, African American, first-episode psychosis patients.


METHODS
Twelve family members of 10 patients were interviewed at length to gather detailed narrative accounts of factors related to untreated psychosis and treatment delay. Using qualitative analysis, verbatim transcripts were reviewed by 2 researchers to identify prominent themes useful for generating future research hypotheses.


RESULTS
Four themes emerged as informative of the period of untreated psychosis before treatment initiation: (1) misattribution of symptoms or problem behaviors (eg, depression, drug use, and adolescent rebellion), (2) positive symptoms causing unusual or dangerous behaviors that served as a catalyst for initiating treatment, (3) views about personal autonomy of an adult or nearly adult patient, and (4) system-level factors (eg, unaffordability of health care and inefficiency on the part of health care providers).


CONCLUSIONS
Family members encountered numerous barriers when seeking treatment, including their own misattributions, the nature of the patient's symptoms, financial issues, and system-level delays. The themes uncovered in this formative analysis merit further exploration with additional qualitative and quantitative research.
Bergner
Erin
E
Department of Behavioral Sciences and Health Education, Rollins School of Public Health of Emory University, Atlanta, GA 30322, USA.
Leiner
Amy S
AS
Carter
Tandrea
T
Franz
Lauren
L
Thompson
Nancy J
NJ
Compton
Michael T
MT
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D017028:Caregivers; D003617:Dangerous Behavior; D005190:Family / Q000523:psychology; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D033262:Narration; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D026684:Personal Autonomy; D011618:Psychotic Disorders / Q000208:ethnology / Q000628:therapy*; D012559:Schizophrenia / Q000208:ethnology / Q000628:therapy*; D014481:United States