title: Factors contributing to the duration of untreated psychosis.
abstract: BACKGROUND
  Shortening the duration of untreated psychosis (DUP) - with the aim of improving the prognosis of psychotic disorders - requires an understanding of the causes of treatment delay. Current findings concerning several candidate risk factors of a longer DUP are inconsistent. Our aim was to identify factors contributing to DUP in a large sample that represents the treated prevalence of non-affective psychotic disorders.
  
  
  METHODS
  Patients with a non-affective psychotic disorder were recruited from mental health care institutes from 2004 to 2008. Of the 1120 patients enrolled, 852 could be included in the present analysis. Examined candidate factors were gender, educational level, migration status, premorbid adjustment and age at onset of the psychotic disorder. DUP was divided into five ordinal categories: less than one month, one month to three months, three months to six months, six months to twelve months and twelve months and over. An ordinal logistic regression analysis was used to identify the risk factors of a longer DUP.
  
  
  RESULTS
  Median DUP was less than one month (IQR 2). The factors migration status (p=0.028), age at onset of the psychotic disorder (p=0.003) and gender (p=0.034) were significantly associated with DUP in our analysis.
  
  
  CONCLUSIONS
  First generation immigrant patients, patients with an early onset of their psychotic disorder and male patients seem at risk of a longer DUP. These findings can assist in designing specific interventions to shorten treatment delay.
authors.affiliation: Department of Psychiatry, University Medical Centre Groningen, University of Groningen, the Netherlands; Rob Giel Research Centre, University Medical Centre Groningen, University of Groningen, the Netherlands. Electronic address: s.y.apeldoorn@umcg.nl.
authors.forename: S Y
authors.initials: SY
authors.lastname: Apeldoorn
authors.affiliation: Department of Psychiatry, Academic Medical Centre, University of Amsterdam, the Netherlands; Department of Psychiatry, University Medical Centre Nijmegen, the Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Sterk
authors.affiliation: Department of Epidemiology, University Medical Centre Groningen, University of Groningen, the Netherlands.
authors.forename: E R
authors.initials: ER
authors.lastname: van den Heuvel
authors.affiliation: Department of Psychiatry, University Medical Centre Groningen, University of Groningen, the Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: Schoevers
authors.affiliation: Department of Psychiatry, University Medical Centre Groningen, University of Groningen, the Netherlands; Rob Giel Research Centre, University Medical Centre Groningen, University of Groningen, the Netherlands.
authors.forename: M A
authors.initials: MA
authors.lastname: Islam
authors.forename: R
authors.initials: R
authors.lastname: Bruggeman
authors.forename: W
authors.initials: W
authors.lastname: Cahn
authors.forename: L
authors.initials: L
authors.lastname: deHaan
authors.forename: R S
authors.initials: RS
authors.lastname: Kahn
authors.forename: C J
authors.initials: CJ
authors.lastname: Meijer
authors.forename: I
authors.initials: I
authors.lastname: Myin-Germeys
authors.forename: J
authors.initials: J
authors.lastname: van Os
authors.forename: D
authors.initials: D
authors.lastname: Wiersma
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000628:therapy*; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult
keywords: Age at onset; DUP; Duration of untreated psychosis; Gender; Migration status