title: The period of untreated psychosis before treatment initiation: a qualitative study of family members' perspectives.
abstract: 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.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health of Emory University, Atlanta, GA 30322, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Bergner
authors.forename: Amy S
authors.initials: AS
authors.lastname: Leiner
authors.forename: Tandrea
authors.initials: T
authors.lastname: Carter
authors.forename: Lauren
authors.initials: L
authors.lastname: Franz
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Thompson
authors.forename: Michael T
authors.initials: MT
authors.lastname: Compton
mesh_terms: 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