title: Obstacles to care in first-episode psychosis patients with a long duration of untreated psychosis.
abstract: OBJECTIVE
  This qualitative study is a sub-study of the early 'Treatment and Intervention in Psychosis Study' (TIPS-2), a program for early intervention strategies for people experiencing a first episode of psychosis. We aimed to improve knowledge about factors that prevent or delay patients with a long duration of psychosis from accessing psychiatric health-care services at an earlier illness stage and their personal views on the impact of ongoing informational campaigns (ICs) on help-seeking behaviour.
  
  
  METHODS
  Following an interpretative-phenomenological approach, eight consecutive TIPS-2 patients with duration of untreated psychosis lasting for more than 6 months were interviewed. The interviews were analysed using a meaning condensation procedure.
  
  
  RESULTS
  Five main themes were identified: (i) participants' failure to recognize symptoms of psychosis; (ii) difficulties expressing their experiences; (iii) concerns about stigma; (iv) poor psychosis detection skills among health-care professionals; and (v) participants' lack of awareness or understanding of ICs.
  
  
  CONCLUSIONS
  The five themes identified may suggest that despite exposure to the targeted ICs, participants were unable to recognize or understand the severity of their symptoms. Further, although family members or others sometimes recognized the initial symptoms of psychosis development, these symptoms were attributed to reasons other than psychosis. Participants reported that health-care personnel also had trouble identifying emerging signs of psychosis. The ICs need to be carefully crafted to relay information to people who do not consider themselves as currently experiencing signs of psychosis.
authors.affiliation: Division of Psychiatry, Regional Centre for Clinical Research in Psychosis, University Hospital of Stavanger, Stavanger, Norway.
authors.forename: Nina
authors.initials: N
authors.lastname: Bay
authors.affiliation: Division of Psychiatry, Regional Centre for Clinical Research in Psychosis, University Hospital of Stavanger, Stavanger, Norway.
authors.forename: Jone
authors.initials: J
authors.lastname: Bjørnestad
authors.affiliation: Division of Psychiatry, Regional Centre for Clinical Research in Psychosis, University Hospital of Stavanger, Stavanger, Norway.|Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
authors.forename: Jan O
authors.initials: JO
authors.lastname: Johannessen
authors.affiliation: Division of Psychiatry, Regional Centre for Clinical Research in Psychosis, University Hospital of Stavanger, Stavanger, Norway.
authors.forename: Tor K
authors.initials: TK
authors.lastname: Larsen
authors.affiliation: Division of Psychiatry, Regional Centre for Clinical Research in Psychosis, University Hospital of Stavanger, Stavanger, Norway.|Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
authors.forename: Inge
authors.initials: I
authors.lastname: Joa
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000523:psychology*; D036301:Qualitative Research; D061665:Time-to-Treatment; D055815:Young Adult
keywords: duration of untreated psychosis; first-episode psychosis; information campaign; obstacles to care