Increased use of primary care during 6 years of prodromal schizophrenia.
Early diagnosis is important for the course of schizophrenia.



To investigate whether prodromal symptoms of schizophrenia lead to increased use of primary care.



A register-based cohort study of 21 894 cases with incident schizophrenia and 437 880 matched controls.



Cases used daytime primary care 43% more than controls during the 6 years before diagnosis (IRR = 1.43; 95% CI: 1.39; 1.48) and 132% more during the last 2 months (IRR = 2.32; 95% CI: 2.27; 2.37), and 34% (IRR = 1.34; 95% CI: 1.23; 1.48) vs. 374% more for out-of-hours services (IRR = 3.74; 95% CI: 3.52; 3.98). Six years before index diagnosis, 30% of cases had at least one psychiatric contact without being diagnosed with schizophrenia, increasing to 75% 1 month before diagnosis.



Increased help-seeking behaviour was seen at least 6 years before index diagnosis, suggesting a 'window' for earlier diagnosis of prodromal schizophrenia.
Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark.|Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Hcb
H
Nørgaard
Research Unit for General Practice, Aarhus University, Aarhus, Denmark.
H
H
Søndergaard Pedersen
Research Unit for General Practice, Aarhus University, Aarhus, Denmark.
M
M
Fenger-Grøn
Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark.
O
O
Mors
Psychiatric Center Copenhagen, Copenhagen University, Copenhagen, Denmark.
M
M
Nordentoft
Research Unit for General Practice, Aarhus University, Aarhus, Denmark.
M
M
Vestergaard
National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
T
T
Munk Laursen
D000328:Adult; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D062706:Prodromal Symptoms; D012042:Registries; D012559:Schizophrenia / Q000175:diagnosis*; D055815:Young Adult
epidemiology; first episode; general practice; schizophrenia