[Pathway to care of people with first episode of schizophrenia, in Chile].
BACKGROUND
It has been considered that the duration of first episode of psychosis is a critical period influencing the clini-cal and psychosocial evolution in people with diagnosis of schizophrenia. However, there is little knowledge about this issue in Low and Middle Income Countries.


OBJECTIVE
To describe the clinical characteristics and contacts with health services of people with first episode of schizophrenia, prior to their diagnoses and initiation of treatment. Sources and methods. The sample included all persons with diagnosis of first episode of schizo-phrenia, in five psychiatric care centers, located in the North, Center and South of Chile. Diagnosis was confirmed with ICD-10 criteria and psychopathology symptoms were explored using PANSS.


RESULTS
The sample was constituted by 48 patients (79.2% men, average age in 23.4 years). The symptom of depression was the first to appear (me-dian of 15 months, before diagnosis). Positive symptoms started in the previous year before diagnosis (delusions, median of 6 months). Positive symptoms triggered the first contact in 77.1% of the patients. Of these cases, 91.7% had medical care in this period (in Primary Health Care Centers and Mental Health Centers). The me-dian for previous contacts was 3.5, but the correct diagnosis was not done at that time.


CONCLUSIONS
Most of the patients had medical contacts for their psychotic symptoms, but their diagnosis were not made within that period, delaying the start of treatment. There is a need to develop strategies to improve diagnosis capabilities in these centers.
Instituto de Salud Poblacional "Escuela de Salud Pública Dr. Salvador Allende", Facultad de Medicina, Universidad de Chile.
Ruben
R
Alvarado
Instituto de Salud Poblacional "Escuela de Salud Pública Dr. Salvador Allende", Facultad de Medicina, Universidad de Chile.
Eliecer
E
Valencia
Instituto de Salud Poblacional "Escuela de Salud Pública Dr. Salvador Allende", Facultad de Medicina, Universidad de Chile.
Carlos
C
Madariaga
Unidad de Salud Mental, Hospital Padre Hurtado. Santiago, Chile.
Francisco
F
Alieste
Instituto de Salud Poblacional "Escuela de Salud Pública Dr. Salvador Allende", Facultad de Medicina, Universidad de Chile.
Alberto
A
Minoletti
Instituto de Salud Poblacional "Escuela de Salud Pública Dr. Salvador Allende", Facultad de Medicina, Universidad de Chile.
Rafael
R
Sepúlveda
D000293:Adolescent; D000328:Adult; D002677:Chile; D042241:Early Diagnosis; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data; D011599:Psychopathology; D011618:Psychotic Disorders / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D011634:Public Health; D012559:Schizophrenia / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy*; D012565:Schizophrenic Psychology; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult